The impact of inclusion of more staff disciplines on patient counts

The inclusion of nursing disciplines over and above GP recording gives a much more complete picture of patient care. Many chronic conditions are increasingly managed by nurses rather than GPs. For many conditions, including nursing contacts in calculations of numbers of patients consulting will likely result in figures that are closer to the population prevalence compared to analysis based on GP contacts only.

This is illustrated by the chart below. It shows the number of patients per 1,000 patients registered who had at least one contact with members of the practice team for selected conditions. It compares the rate calculated from GP-only data to the rates using GP and practice nurse data and full practice team data (GP, practice nurse, district nurse and health visitor).

The rates for diabetes and asthma notably increase when data from additional staff disciplines within the practices are included, mostly through the addition of the practice nurse contacts. However, for other conditions such as depression and acute upper respiratory infections, there is little change with the addition of other disciplines, indicating that although patients may have been seen by members of several disciplines for these conditions, they generally are seen at least once by a GP. Although the effect of adding practice nurse data can be substantial, the addition of community nursing data appears to have a relatively small impact on patient counts.

For three of the conditions included in the chart below (asthma, diabetes and depression) further details are provided in the "Information on specific conditions " section of this website, including estimated numbers of patients and consultations by age group and gender, for the financial years 2003/04 to 2006/07.

Estimated number of patients consulting ¹ in the financial year 2005/06, per 1,000 population ²
for selected conditions ³, using GP-only, GP and practice nurse, or all four disciplines ⁴

¹ The number of patients with at least one contact for the specified condition per 1,000 population during the specified year. Rates are standardised for age, gender and deprivation.
² Population source: Community Health Index (CHI) record, as at 30 September 2005.
³ Classified using ISD's Read code Groupings (RCGs) .
⁴ Based on 44 PTI practices that submitted complete PTI data for the year ending 31 March 2006.
⁵ Excluding acute pharyngitis, acute tonsillitis, acute laryngitis & tracheitis.

Note: Following a substantial review of PTI data and subsequent revisions to the methodology for all PTI analyses, direct comparisons with figures produced prior to 27th March 2007 are not valid.  See the Note of Revisions for further information.

Figures underlying this chart and comparable figures for 2003/04 to 2006/07 are provided here in excel format  (77KB).

Source: Practice Team Information (PTI), ISD Scotland (last updated 25 March 2008)