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The advance of primary care information

While the NHS has a rich, central resource of acute care information at its fingertips, the same cannot be said for primary care, writes Dave Roberts

This is far from ideal for an area responsible for a huge level of patient activity, in particular GP practices, which see some 300 million appointments made every year. The result is a disjointed picture, drawn from several different sources, for commissioners and decision makers to rely on. This lack of nationally co-ordinated information clearly hampers efforts to develop the best policies, tackle health inequalities and target resources in the most effective way.

However, the NHS Information Centre is aiming to tackle the issue by introducing a general practice extraction service. This is a centrally managed primary care data extraction and analysis service that will collate data from NHS GP systems to provide key information. Its main purpose is to support better patient care.

"The ultimate beneficiaries of the general practice extraction service will be patients"


The service is being developed in consultation with a range of organisations, including the GP Council, Royal College of GPs, NHS Connecting for Health and the Department of Health. The Information Centre consulted potential suppliers over the summer to refine its specification for the service. It received feedback from 40 organisations and will tender for suppliers for the service later this financial year.

Benefits to cohesion

Providing a cohesive approach to primary care information, the service will deliver:

  • better access to primary care data to support better national and local decisions aimed at improving services for patients;

  • better information to support local commissioners to secure health improvements and address health inequalities;

  • better coverage for current and future primary care clinical audits;

  • better-informed decisions about how resources should be allocated to improve efficiency and patient outcomes;

  • financial savings with reductions in the amount of money spent on current and proposed data extractions;

  • better national and local public health surveillance;

  • improvements to the way extracts are managed so that they do not disrupt the principal work carried out by clinical systems;

  • a reduction in the time GPs and their practice staff need to spend on administrative burdens;

  • a focus for the development of clinical and data standards in primary care.

This is contrast with the current sources of primary care information for the NHS, some of which cover all practices but only extract a limited selection of data. The Quality Management and Analysis System, for example, only holds information used to support the quality and outcomes framework, while information extracted for clinical audits focuses purely on defined clinical areas.

Other sources, which are broader in scope, are all based on samples of practices, meaning data is not appropriate for many purposes.

Patient outcomes

The ultimate beneficiaries of the general practice extraction service will be patients, who will receive better services as a result of the information the service provides. GPs will also see a real difference, as the service will mean the current, predominantly manual data extractions will be replaced by more automated services. This also means practice staff will need to spend less time on clerical tasks associated with data collection.

The priority for all those involved in delivering the service is to ensure it guarantees patient confidentiality and integrates seamlessly with existing GP databases. The roll-out of the service will be in two stages. Due to be delivered in 2009, stage one will cater for national enquiries from customers such as the Department of Health and NHS central bodies. Stage two will see the service widened to accommodate other enquiries such as those from NHS local organisations and researchers.

For more information on the general practice extraction service, visit www.ic.nhs.uk

  • Author: Dave Roberts .Dave Roberts of The NHS Information Centre.

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Reader Response

Added: Friday, 19 September 2008 16:03 BST
Anonymous, Dunstable, United Kingdom

Hard to know where to start on this!
One of the complaints from PBCs is always the lack of data and the poor quality of data provided by the acute sector: if the information centre *does* have good quality data, I wish they would share it with my PBC consortium!
There is also a presumption that there is robust data within general practice on problems where data has not been entered uniformly or for a particular purpose.
Data extracted across the country - all systems - for the IM&T DES suggests that this is not true - data relating to QOF is uniformly recorded, but there is a very wide difference in other areas.
The First Law of Informatics - data is only valid for the purpose for which it was gathered - certainly applies in general practice!

If data extracted from general practice records used for clinical management is to be used for resource allocation, I suspect there will be unintended consequences, and resources will be diverted from areas of need to areas of good data entry: lack of *recorded* activity or need does not mean lack of activity or need: in many cases it will reflect just a lack of need to record that activity in extractable forms.

I appreciate the desire for information to micromanage the entire NHS: just don't think that because it is or is not recorded on a computer, the validity - or lack of validity - of the information has changed.


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