Consultation on Health and Social Care Statistical Products

General questions

What are the national general practice profiles?

The national general practice profiles includes more than 150 general practice level indicators that have been developed for practices across England.

The indicators cover practice population, life expectancy, deprivation, patient satisfaction, the Quality and Outcomes Framework (QOF), cancer services, child health, antibiotic prescribing and others.

Who produces the profiles?

The Office for Health Improvement and Disparities (OHID), led by Digital Innovation and Data Science and with contributions from other teams.

How should these profiles be used?

Feedback indicates that the profiles are helpful tools for decision making at all levels. They seem to be useful in giving practice staff a clear overview of the practice and an insight into the possible health needs of the population the practice serves

Can I choose my GP based on these profiles?

The profiles provide a wide range of information at a practice level. People may find this useful when choosing whether to register at a particular practice. However, this is not the purpose of the profiles so you should be careful when examining the data.

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Available geographies and area selection

Which practices are included in the profiles?

To be part of the Profiles, practices now have to meet one of the following criteria:

  • practice code exists in QOF (2022/23) AND practice list size in QOF is >= 750
  • practice code is in Open Exeter (April 2023) AND Open Exeter practice list size is >= 750 AND the practice has valid data in the GP-Patient Survey (2023)

For more details, see the rules of inclusion and included practices.

How can I find my GP practice?

There is an area search box on the introduction page. To search for a practice, you need at least one of the following:

  • practice name
  • ODS code
  • postcode - you can use only the first part to identify all practices in the area, for example NW1

The results are shown as a list and as pins on the map. To see data for the practice of interest, click on its name or on the corresponding pin on the map.

The same area search is accessible from within the tool when the data view (top left menu) is set to 'Map'. You can use the geography selector in the grey area towards the top of the page. From there:

  1. Set the 'Area type' to GP, 'Area type to group areas by' to PCN or an ICB sub-location
  2. Choose the broader area of interest. For example, a particular PCN or ICB sub-location 
  3. Select the practice of interest

Why is my Primary Care Network (PCN) not listed? 

Since 2019, groups of GP practices have built Primary Care Networks (PCNs). However, PCNs change often. You should be careful when looking at PCN values to be clear which practices are assumed to contribute to the PCN value.

GP-to-PCN lookup in Fingertips is updated twice a year, therefore it’s possible that the tool contains a more recent version than that published at source.

To avoid a situation where indicator values are potentially based on a different set of practices than those shown in the tool (as belonging to a given PCN), Fingertips does not show the original PCN values but calculates them based on the current lookup table. Reference to the lookup version used is on the home page of the profile and included in the area label.

Can I see data for ICBs and ICB sub-locations?

Yes, you can choose to view data for GPs in a particular ICB sub-location (formerly a CCG) or look at ICB-level data (for example, display indicator values for all ICBs in England).

For indicators and time periods where ICB values are not readily available, these have been auto-generated and added into the profiles wherever possible. 

What comparisons can I make?

Practices in the same PCN or an ICB sub-location (formerly CCG) can be compared between them within a single ICB or NHS region. You can also compare indicator values for PCNs and ICB-sub locations.

By default, benchmark is set to England. However, you can change it to match the area grouping option selected. To do that, click on the 'Benchmark' option below the main menu and choose a different comparator.

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Data views and interpretation

Which data views are supported by the profiles?

We recommend to see the spine charts available from the 'Area profiles' view and check other data views. Depending on the 'Area type' selected, the profiles may support different ways of visualising the data. For most types of areas, they support the whole suite of available data views.

There’s a more detailed description in a dedicated document available on the home page of the profile, or in the Fingertips user guide

Why does the timeline in the 'Trends' view differ between indicators?

The charts show the trend for a current indicator over as many years as it has been included in the profiles, which is up to twelve years. However, many indicators do not have such a long timeline because they are technically new due to substantial changes in the definition. In those cases, trends are only displayed for the most recent period that is consistent enough to allow comparison over time.

Why do some indicators have blue or yellow blobs and others have blobs in shades of one colour?

The circles/blobs you can see on the spine charts represent the practice value. These are available from the 'Area profiles' view.

For many indicators. it’s possible to calculate the window of certainty around a value, this is the range between the confidence limits. Where confidence limits are available the value may be statistically and significantly different from the mean or not. If the value is not significantly different, then blobs are coloured yellow. If it is different, blobs are blue.

If we cannot determine statistical significance, we can still rank the values and put them into groups. When no good-bad judgement is appropriate, we apply five shades of blue (from darkest for the lowest 20% of values to the lightest shade for the top 20%). Five shades of purple (darkest = worst) are applied when a judgement is possible.

A practice is an outlier for a lot of indicators (blue), what does this mean?

The colour of the blobs on the spine chart denotes statistical significance and suggests that it is worth seeking an explanation as to why there is a difference compared with the national mean. It does not imply that a different colour is wrong.

Why is the England average near to the top of the range for many indicators?

Some indicators have a very skewed distribution, with most of practices attaining close to the maximum available for a given indicator. This means that the average (arithmetic mean) for practices across England is also close to the maximum and, therefore, is not in the middle of the range.

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Quality and Outcomes Framework (QOF)

Why do the profiles show intervention rates instead of achievement scores?

In line with other OHID (former PHE) products, the national GP profiles show the intervention rate where the denominator includes all the patients to whom the indicator applies, regardless of exceptions (or, since 2019/20, Personalised care adjustments (PCAs)). This is consistent with the advice of HSCIC (page16, downloaded on 23 November 2020), which states: "Percentage of patients receiving the intervention gives a more accurate indication of the rate of the provision of interventions as the denominator for this measure covers all patients to whom the indicator applies, regardless of exception status."

Therefore, from a public health perspective, we consider an intervention rate to be a better measure to compare GPs. 

This approach supports the main aim of the tool, which is to highlight variation and encourage conversation about causes of variation and whether it is warranted or not. We are not suggesting that every practice can or should achieve a 100% intervention rate for every indicator since there are patients for whom it would not be desirable to be included. 

Why are QOF indicators not age-standardised? 

It’s impossible to age-standardise the data because QOF data only includes information regarding the age of the patients in very few cases and very roughly.

The age distribution of the practice populations can have a strong effect on the results of the data. For example, a low prevalence of an age-related condition like chronic obstructive pulmonary disease may be the result of a very young practice population and does not mean that the disease is particularly rare in the area among the age groups that are usually affected by it.

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Other questions

Has COVID-19 affected the GP profiles?

Covid-19 has changed the work of GP practices in many ways. Data is available for 2021/22 for the indicators shown in the GP profiles. However, from these sources it cannot yet be said with certainty to which degree the indicators show an effect on the health of the population, the procedures or behaviours that have changed, and the longer-term consequences.

Can I print the whole profiles? 

There are no printable reports associated with the GP profiles. We recommend looking at them online. This provides better insights than a print due to a wide variety of displays and comparisons.

If a hard copy is needed, we suggest using Data view > 'Area profiles' and the feature: More options > Download image for the Topic(s) of interest and to assemble the images into a document.

Where can I find more information?

A national GP user guide and a file explaining in detail which practices are included or excluded are in the profile’s home page. Metadata for all indicators can be found directly in the profiles by setting 'Data view', in the top left menu, to 'Definitions'. From there, links to source data are available to obtain further details from the original data providers.

Technical guidance and help with methodological questions is also available via the link on the Fingertips tool. There are also several other resources explaining the features and functionality of Fingertips in more general terms.

There’s little GP-level data in other Fingertips profiles that is not also shown in the National GP profiles, however Local Health also contains small area data that can be of interest for primary care-related questions.

For specific questions relating to these profiles, email ProfileFeedback@dhsc.gov.uk.