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Br J Gen Pract. 2020 Feb 10. pii: bjgp20X708185. doi: 10.3399/bjgp20X708185. [Epub ahead of print]

Regional variation in practitioner employment in general practices in England: a comparative analysis.

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Centre for Primary Care Research, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester.
Alliance Manchester Business School, University of Manchester, Manchester.



In recent years, UK health policy makers have responded to a GP shortage by introducing measures to support increased healthcare delivery by practitioners from a wider range of backgrounds.


To ascertain the composition of the primary care workforce in England at a time when policy changes affecting deployment of different practitioner types are being introduced.


This study was a comparative analysis of workforce data reported to NHS Digital by GP practices in England.


Statistics are reported using practice-level data from the NHS Digital June 2019 data extract. Because of the role played by Health Education England (HEE) in training and increasing the skills of a healthcare workforce that meets the needs of each region, the analysis compares average workforce composition across the 13 HEE regions in England RESULTS: The workforce participation in terms of full-time equivalent of each staff group across HEE regions demonstrates regional variation. Differences persist when expressed as mean full-time equivalent per thousand patients. Despite policy changes, most workers are employed in long-established primary care roles, with only a small proportion of newer types of practitioner, such as pharmacists, paramedics, physiotherapists, and physician associates.


This study provides analysis of a more detailed and complete primary care workforce dataset than has previously been available in England. In describing the workforce composition at this time, the study provides a foundation for future comparative analyses of changing practitioner deployment before the introduction of primary care networks, and for evaluating outcomes and costs that may be associated with these changes.


employment; general practice; health workforce; primary care networks; statistics and numerical data


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