Page last updated: 25-MAR-2008

General Practice - Practice Team Information (PTI)

Summary of main findings (2006/07)

  • Number of consultations in Scotland, by discipline.  GP and practice nurses together had a total estimated 23.7 million face-to-face contacts with patients in 2006/07. This represents an increase of roughly 400,000 per year from the 22.6 million estimated for 2003/04. Practice nurses have a large share of the activity, with almost half as many consultations as GPs. The 23.7 million total for 2006/07 breaks down to about 16.0 million contacts for GPs and 7.7 million contacts for practice nurses. Whereas GP contact numbers appeared to decrease slightly between 2003/04 and 2005/06 (from 16.0 million to 15.7 million), by 2006/07 they were back up to the same level as in 2003/04. In contrast, the number of practice nurse contacts has been rising continuously over the four years for which these data have been collected (from 6.5 million in 2003/04 to 7.7 million in 2006/07, although the rise between 2005/06 and 2006/07 has not been as evident as in previous years.
  • Proportion of practice population seen, and number of contacts per patient.  Of the patients registered with a practice, over 8 in 10 (82%) had at least one face-to-face contact with a GP or practice nurse in 2006/07. The overall average (mean) number of contacts per registered patient was 4.1; this average does however include those patients not visiting their practice at all. Over three quarters of registered patients (76%) saw a GP at least once during the year, and for these patients the median number of GP contacts was 3. Less than 5% of these patients had more than 10 contacts in the year. More than 44% of registered patients saw a practice nurse at least once during the year, and these patients had a median of 2 practice nurse contacts in the year, with 3% of these patients having more than 10 contacts. However, these figures can vary greatly between practices.
  • Contact rates by gender and age group. Apart from the youngest and oldest age groups, contact rates are (much) higher in females compared to males. Contact rates are lowest in the 5-14 year age band (less than 2 GP or practice nurse contacts per year) and highest in the oldest age band of 75 plus (over 8 per year).
  • Most common reasons for consultations - conditions and activities.  The most frequent reason to visit a GP is for digestive/abdominal symptoms and signs, but when combining GP and practice nurse data, hypertension is the most common reason for a consultation. The most common activity for practice nurses is taking blood samples.
  • Workload associated with QOF-related conditions.  Contacts for QOF-related conditions represent nearly a quarter of all GP and practice nurse contacts. Practice nurses are increasingly involved in managing chronic conditions, and more than 30% of their contacts are for QOF-related conditons. However, these figures also illustrate that whilst the management of the chronic conditions included in the QOF accounts for a substantial part of the practice workload, the QOF by no means covers all conditions encountered in general practice.
  • Information on specific conditions.  For many of the individual conditions for which data are presented, the estimated number of contacts for GPs and Practice Nurses combined decreased between 2003/04 and 2006/07. This may be a result of improvements in treatments and risk factor levels or changes in the natural history of some of these conditions. Where conditions have been included in the QOF, clinicians may have become more precise in their coding; for example if patients with suspected angina used to be coded as having angina, now they would only get an angina code once the diagnosis has been confirmed.
  • Information on dementia.  In contrast to the above, estimated numbers of GP contacts for dementia, although falling from 33,500 in 2003/04 to 20,650 in 2005/06, increased for 2006/07 to 28,150. This observation is likely due to the inclusion of dementia as a QOF condition from 2006/07 onwards. Under QOF guidance, practices are required to record, using clinical codes, which of their patients have dementia, and also to record in a systematic way whether patients have had their care reviewed within a given time period. This is likely to have resulted in improved clinical coding and thus identification of this condition in the PTI data set. Whilst practice nurses continue to have relatively few contacts specifically for dementia, the increase for GPs is very apparent. In addition, information available for district nurses for 2003/04 to 2005/06 indicates that they too clearly provide dementia-related care, in accordance with the typically older age profile of the patients served by this professional group.