General practice activity: April 2023 to March 2024
Information on appointments in general practices including analysis of mode, type of practitioner and consultation; and selected additional activities for April 2023 to March 2024.
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Introduction
The purpose of this release is to provide statistics on the key activities performed in general practices in Wales. The main focus is on appointment statistics, with supplementary analysis of other activities, including referrals made, fit notes issued and telephone calls, letters, emails and other digital communications.
To account for public holidays and differences in the number of days in each month, monthly statistics are presented on a per working day basis, as well as overall totals.
Statistics on appointments are estimates, for data quality reasons explained in the quality report. As these statistics are newly produced, with known limitations they are classified as ‘official statistics in development’.
All activity data are collected from the Primary Care Information Portal (NHS Wales Digital Health and Care Wales, which collects activity data from each general practice in Wales.
Main points
- In 2023-24, there were an estimated 19.8 million appointments scheduled in general practices, with 18.7 million (or 94.6%) attended appointments and 1.1 million (or 5.4%) not attended.
- 11.9 million attended appointments were face-to-face, an increase of 1.7% from the previous year.
- 6.3 million appointments were remote, a decrease of 16.9% from the previous year.
- Two thirds (67.1%) of attended appointments were with a GP or independent prescriber and one third (32.9%) of appointments were with a nurse, allied health professional or other clinical staff member.
- The majority of attended appointments (63.2%) were for chronic, planned or non-acute reasons, while 36.8% were for urgent or acute reasons.
- Nearly nine out of ten attended appointments with nurses, allied health professionals or other clinical staff were for chronic, planned or non-acute reasons.
- GP or independent prescriber attended appointments were split nearly evenly between chronic, planned or non-acute reasons and urgent or acute reasons.
- 1.6 million referrals for specialist services were made and 620,000 fit notes were issued.
- 29.1 million calls were received, equivalent to 120,000 per working day. Six out of ten calls were answered within two minutes.
- 6.8 million letters or emails were issued, 6.0 million text messages were sent and received, and 5.1 million digital requests were submitted.
Appointments
The term ‘appointment’ refers to all patient-related activities recorded in general practice’s appointment book. The large majority of activities recorded will be traditional appointments where a patient has a consultation with a GP, nurse or other health professional. The term will also capture some other activities which staff perform for patients, but without having a consultation (such as a medicine review) if it’s recorded in the appointment book. It will not capture any patient related activities which are not recorded in the appointment book. Further information on appointments is published in the quality report.
Statistics are presented on the estimated number of appointments attended and not attended, with further analyses on the mode of consultation, type of practitioner and reason for appointment.
Figure 1: Estimated average number of appointments per working day each month, by appointment status (attended or not attended), October 2021 to March 2024
Source: Primary Care Information Portal, Digital Health and Care Wales
Estimated number of appointments by appointment status, area and month on StatsWales
Overall, there were an estimated 19.8 million appointments scheduled in 2023-24, a decrease of 6.0% from the previous year. This is equivalent to an average of 79,000 appointments scheduled per working day in the year.
The proportion of appointments by appointment status is broadly stable each month. In 2023-24, on average (mean) 94.6% of appointments were attended and 5.4% were not attended, the same as the previous year.
There were an estimated 18.7 million appointments attended in 2023-24, a decrease of 6.0% (1.2 million) from the previous year. During the year, estimated daily attended appointments ranged from 68,000 in December 2023 to 84,000 in October 2023. The estimated number of daily attended appointments decreased in eleven out of twelve months, when compared with the same month in the previous year.
An estimated 1.1 million appointments were not attended in 2023-24, a decrease of 5.9% (67,000) from the previous year. During the year, estimated daily appointments that were not attended ranged from 3,700 in August 2023 to 6,300 in October 2023. The estimated number of daily appointments that were not attended decreased in eight out of twelve months, when compared with the same month in the previous year.
Figure 2: Estimated average number of appointments attended per working day each month, by mode of consultation, October 2021 to March 2024 [Note 1]
Description of Figure 2: Line chart showing that the majority of estimated appointments attended were face-to-face and the proportion of face-to-face appointments has broadly increased since between October 2021 and March 2024, with monthly variations. Conversely, the proportion of remote appointments has been on a downward trend over the same period.
Source: Primary Care Information Portal, Digital Health and Care Wales
Estimated number of attended appointments by appointment category, area and month on StatsWales
[Note 1] Attended appointments that could not be mapped to mode of consultation are excluded from the chart and the denominator of the relevant percentage calculations. Between 1.2% and 2.1% of all attended appointments per month could not be mapped, between October 2021 and March 2024.
Nearly two thirds (64.7%) of all attended appointments were face-to-face in 2023-24, an increase of 4.7 percentage points from the previous year.
There were an estimated 11.9 million face-to-face appointments in 2023-24, an increase of 1.7% from 2022-23. This is the equivalent of 48,000 face-to-face appointments each working day in the year.
The estimated number of average daily face-to-face appointments ranged from 43,000 in August 2023 to 57,000 in October 2023. The estimated number of daily face-to-face appointments increased in nine of the twelve months, when compared with the same months in the previous year.
A little more than one third (34.0%) of all attended appointments were carried out remotely in 2023-24, a decrease of 4.6 percentage points from the previous year.
There were an estimated 6.3 million remote appointments in 2023-24, a decrease of 16.9% from the previous year. This is equivalent to 25,000 remote appointments each working day in the year.
The estimated number of average daily remote appointments ranged from 23,000 in December 2023 to 27,000 in May 2023. The estimated number of daily remote appointments decreased in all twelve months of the year, when compared with the same months in the previous year.
An estimated 220,000 home visit appointments took place in 2023-24, a decrease of 17.0% from 2022-23. This is equivalent to 890 home visit appointments each working day in the year.
A further 240,000 appointments were attended, but did not have the mode of consultation recorded.
Figure 3: Estimated average number of appointments attended per working day each month, by type of practitioner, October 2021 to March 2024 [Note 1] [Note 2] [Note 3]
Description of Figure 3: Line chart showing that the estimated average number of appointments attended per working day with a GP or independent prescriber was close to double the number for nurse or other clinical staff.
Source: Primary Care Information Portal, Digital Health and Care Wales
Estimated number of attended appointments by appointment category, area and month on StatsWales
[Note 1] Attended appointments that could not be mapped to type of practitioner are excluded from the chart and are also excluded from the denominator of the relevant percentage calculations. Between 8.7% and 11.3% of all attended appointments per month could not be mapped to practitioner type between October 2021 and March 2024.
[Note 2] Independent prescribers are non-GP staff who are qualified to prescribe, as defined by NHS Wales Shared Services Partnership. Advanced nurse practitioners and pharmacists who are registered as independent prescribers, should be counted in the ‘GP or independent prescriber’ category.
[Note 3] Nurses, allied health professionals or other clinical staff include all staff providing clinical services to patients who are not registered to prescribe medication. This may include staff such as physiotherapists, phlebotomists, and health care assistants, but will not include any administrative staff.
Two thirds (67.1%) of all appointments attended were carried out by a GP or independent prescriber in 2023-24, a decrease of 1.0 percentage points from the previous year.
An estimated 11.4 million appointments were carried out by a GP or independent prescriber in 2023-24, a decrease of 6.5% from 2022-23. This is equivalent to 46,000 GP appointments each working day in the year.
The estimated number of average daily GP appointments ranged from 42,000 in August 2023 to 48,000 in January 2024. This number decreased in eleven of twelve months, when compared with the same month in the previous year.
A third (32.9%) of attended appointments were carried out by a nurse or other clinical staff in 2023-24, an increase of 1.0 percentage points from the previous year.
An estimated 5.6 million appointments were carried out by a nurse, allied health professional or other clinical staff member in 2023-24, a decrease of 2.2% since 2022-23. This is equivalent to 22,000 nurse, allied health professional or other clinical staff appointments each working day in the year.
The estimated number of average daily nurse, allied health professional or other clinical staff appointments ranged from 19,000 in December 2023 to 30,000 in October 2023. This number decreased in eight of twelve months, when compared with the same month in the previous year.
Nurses or other clinical staff carry out markedly more appointments in October than in any other month, which corresponds to the peak of the flu jab programme.
A further 1.7 million appointments were attended but did not have the practitioner type recorded.
Figure 4: Estimated average number of appointments attended per working day each month, by reason, October 2021 to March 2024 [Note 1]
Description of Figure 4: Line chart showing that the estimated average number of chronic, planned or non-acute attended appointments per working day each month was close to double the number for urgent or acute attended appointments.
Source: Primary Care Information Portal, Digital Health and Care Wales
Estimated number of attended appointments by appointment category, area and month on StatsWales
[Note 1] Attended appointments that could not be mapped to reason are excluded from the chart and are also excluded from the denominator of the relevant percentage calculations. Between 1.2% and 2.1% of all attended appointments per month could not be mapped to reason for appointment between October 2021 and March 2024.
A little fewer than two thirds (63.2%) of attended appointments were for chronic, planned or non-acute reasons in 2023-24, an increase of 1.0 percentage points from the previous year.
An estimated 11.7 million appointments were attended for chronic, planned or non-acute reasons in 2023-24, a decrease of 4.2% from 2022-23. This is equivalent to 47,000 appointments for chronic, planned or non-acute reasons per working day in the year.
The estimated number of average daily appointments for chronic, planned or non-acute reasons ranged from 41,000 in December 2023 to 56,000 in October 2023. This number decreased in eleven of twelve months, when compared with the same month in the previous year.
A little more than one third (36.8%) of attended appointments were for urgent or acute reasons in 2023-24, a decrease of 1.0 percentage points from the previous year.
An estimated 6.8 million appointments were attended for urgent or acute reasons in 2023-24, a decrease of 8.2% from the previous year. This is equivalent to 27,000 appointments for urgent or acute reasons per working day in the year.
The estimated number of average daily appointments for urgent or acute reasons ranged from 25,000 in August 2023 to 29,000 in March 2024. This number decreased in eleven of twelve months, when compared with the same month in the previous year.
There has been a clear increase in the estimated average number of chronic, planned or non-acute attended appointments per working day in October each year, which may be explained by general practices implementing the flu jab programme in addition to their regular work. In contrast, the trend for urgent or acute appointments is more stable throughout the year.
A further 240,000 appointments were attended but did not have the reason for consultation recorded.
Additional analyses of appointments data
In 2023-24, just more than seven in ten face-to-face appointments attended were for chronic, planned or non-acute reasons (70.6%) and just fewer than three in ten were for urgent or acute reasons (29.4%).
In contrast, there was nearly an even split between the proportion of remote appointments attended for chronic, planned or non-acute reasons (50.6%) and for urgent or acute reasons (49.4%).
Nurses, allied health professionals or other clinical staff carried out proportionally more chronic, planned or non-acute appointments (and proportionally fewer urgent or acute appointments) than GPs or independent prescribers. In 2023-24, 88.2% of appointments carried out by nurses or other clinical staff were for chronic, planned or non-acute reasons and 11.8% were for urgent or acute reasons. GP appointments were split almost evenly with 51.1% of estimated appointments for chronic, planned or non-acute reasons and 48.9% for urgent or acute reasons.
Selected additional activities
General practices have been required to submit data for selected additional activities via the Primary Care Information Portal (PCIP), from 1 July 2022, as a result of a quality improvement project contained in the 2021-22 Quality Assurance and Improvement Framework (QAIF).
Practices submit data for the following activities: total number of calls to practices, calls answered within two minutes, calls not answered, text messages sent and received, fit notes issued, referrals made, items issued via prescription, total digital requests submitted to practices and administrative communications issued (letters or emails). Statistics are published for each additional activity in this release with the exception of ‘items issued via prescription’, as prescriptions data is already published as part of an established ‘primary care prescriptions’ statistical release. See the quality report for definitions of each activity.
As consistent data for additional activities has only been collected from July 2022, comparisons between the financial year 2023-24 and 2022-23 are limited to the nine months (July to March) for which there is data in both years.
Figure 5: Average number of referrals made by practices, per working day in each month, July 2022 to March 2024
Description of Figure 5: Line chart showing that the trend for the average number of referrals made by practices per working day each month has been broadly steady since January 2022, with some month-to-month variations.
Source: Primary Care Information Portal, Digital Health and Care Wales
Counts of selected additional activities by area and month on StatsWales
The number of referrals includes referrals made by any member of practice staff, to another healthcare provider for specialist treatments or testing. Referrals are most commonly made to secondary care hospital settings but are also made to other primary care and community health providers.
More than 1.6 million referrals were made by staff at general practices in 2023-24, equivalent to 6,400 per working day in the year.
The daily average ranged between 5,700 in December 2023 to 7,000 in October 2023, and the number increased in all nine comparable months compared to the previous year.
Note that referrals data presented here is a measure of activity performed in general practices, therefore it is different to the number of GP referrals for first outpatient appointments published on StatsWales which is a measure of new patient pathways opened in NHS secondary care.
Figure 6: Average number of fit notes issued by practices, per working day in each month, July 2022 to March 2024
Description of Figure 6: Line chart showing that the average number of fit notes issued by practices per working day each month has been broadly stable over the time series, with month-to-month variations, and noticeable peaks in January and October.
Source: Primary Care Information Portal, Digital Health and Care Wales
Counts of selected additional activities by area and month on StatsWales
A fit note is a statement of fitness for work, also known as a ‘med 3’, that can enable an individual to access health-related benefits or evidence eligibility for statutory sick pay. Fit notes issued by both GPs and trained non-GP practice staff are included in these statistics. Fit note extensions are also included.
Nearly 620,000 fit notes were issued by practices in 2023-24.
The daily average number of fit notes issued ranged between 2,200 in August 2023 and 2,700 in January 2024.
There was little variation when compared with the previous year, with both years averaging 2,500 fit notes issued per working day over the nine comparable months combined.
Figure 7: Average number of telephone calls received, answered in two minutes and not answered per working day in each month, July 2022 to March 2024
Description of Figure 7: Line chart showing that more than half of all calls received by practices were answered within two minutes and one in every eight calls received was not answered.
Source: Primary Care Information Portal, Digital Health and Care Wales
Counts of selected additional activities by area and month on StatsWales
In 2023-24, nearly 29.1 million calls to the main practice telephone line were received by practices, equivalent to an average of 120,000 per working day.
Average daily calls ranged from 100,000 in June 2023 to 130,000 in April 2023 and was lower in seven of the nine months for which there was comparable data in the previous year.
Nearly 17.7 million calls were answered within two minutes by practices in 2023-24, equivalent to 60.8% of all calls received in the year.
Average daily calls answered within two minutes ranged between 65,000 in June 2023 and 77,000 in April 2023 and was lower in seven of the nine months for which there was comparable data in the previous year.
Calls not answered counts calls which did not result in a practice staff member speaking to the caller. This includes calls where the caller obtained the information they required from the practice’s automated message, so did not need to speak to a practice staff member, and all calls to practices outside of opening hours. Nearly 4.6 million calls were not answered in 2023-24, equivalent to 15.7% of all calls received in the year.
Average daily calls not answered ranged from 16,000 in July 2023 to 21,000 in April 2023 and was higher in five of the nine months for which there was comparable data in the previous year.
Figure 8: Average number of letters or emails sent and text messages sent and received by practices to patients, per working day in each month, July 2022 to March 2024
Description of Figure 8: Line chart showing that the average number of letters or emails issued by practices per working day has been on a slight upward trend since December 2022, with a peak in August 2023. The average number of text messages sent and received by practices per working day has been on an overall upward trend with large peaks in the autumns of each year.
Source: Primary Care Information Portal, Digital Health and Care Wales
Counts of selected additional activities by area and month on StatsWales
Just more than 6.8 million letters or emails were issued by practices in 2023-24. The daily average ranged from 25,000 in June 2023 to 33,000 in August 2023 and increased in seven out of the nine comparable months from the previous year.
Just more than 6.0 million text messages were sent and received by practices in 2023-24. The daily average ranged from 16,000 in June 2023 to 37,000 in October 2023 and increased in all nine comparable months from the previous year.
Figure 9: Average number of digital requests submitted to practices, per working day in each month, July 2022 to March 2024
Description of Figure 9: Line chart showing that the average number of digital requests submitted to practices per working day each month has been on a clear upward trend since July 2022.
Source: Primary Care Information Portal, Digital Health and Care Wales
Counts of selected additional activities by area and month on StatsWales
Examples of digital requests include patients requesting appointments, repeat prescriptions, or test results through platforms such as eConsult, Mysurgery app, MyHealth, or live chats.
More than 5.1 million digital requests were submitted to practices in 2023-24.
The daily average ranged from 18,000 in June 2023 to 24,000 in March 2024, and increased markedly in all nine comparable months from the previous year.
Quality and methodology information
Practices are able to revise appointment data for mode of consultation, type of practitioner and reason for appointment at any time. This publication is based on data extracted from the Primary Care Information Portal on 7 June 2024.
All numbers in this report are rounded depending on the scale of the number. For example, numbers in the millions are rounded to the nearest one hundred thousand; numbers in the hundred thousands are rounded to the nearest ten thousand, and so on.
Detailed quality information and a glossary of terms is published in the statistical quality report.
Statement of compliance with the Code of Practice for Statistics
Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.
These official statistics in development demonstrate the standards expected around trustworthiness, quality and public value in the following ways.
Trustworthiness
The requirement for general practices to submit activity data via the Primary Care Information Portal (PCIP) was underpinned by a quality improvement project contained in the 2021-22 Quality Assurance and Improvement Framework (QAIF).
Approval to publish statistics was subsequently granted by the Data Quality System Governance Group in Digital Health and Care Wales (DHCW) and General Practitioners Committee (GPC) Wales.
The published figures are compiled by professional analysts using the latest available data and applying methods using their professional judgement and analytical skillset.
These statistics are pre-announced on the Statistics and Research area of the Welsh Government website. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice for Statistics.
Quality
Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs.
See the quality report for further information.
Value
The purpose of this statistical release is to inform users about activity in general practice.
These statistics are published quarterly with a three-month lag between the end of the reference period of the latest statistics and the publication date. Statistics are published as data tables on StatsWales with an accompanying headline every quarter. An in-depth report is also published annually in HTML format with analysis, charts and commentary focusing on the latest financial year.
See the quality report for further information.
Related statistics on general practice
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Well-being of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.