Introduction

Continuous improvement to the quality of GP appointment data (GPAD) reporting will enable a better understanding of how appointments are planned and managed locally. This will help inform local operational business functions and national policy and planning decisions, as well as to monitor progress against the Primary Care Access Recovery Plan, all with the aim of delivering for patients.

Practices and Primary Care Networks (PCNs) can be rewarded for improving their appointment recording through the Local Capacity and Access Improvement Payment (CAIP) and the Direct Enhanced Service Investment and Impact Fund (indicator ACC-08).

The purpose of this guidance is to support practices, PCNs and integrated care boards (ICBs) to ensure that GPAD recording is being undertaken accurately locally by consolidating key information together in one place.

Guide to accurate appointment recording and areas for improvement

The three key areas for accurate appointment recording are category, service setting and mode.

Categories

Standardised national GP appointment categories were introduced in 2021/22 to better capture GP appointment activity. The GP appointment categories are subdivided in three context types:

• Care related encounter: These categories involve the patient and can be any modality e.g. face-to-face appointments, telephone consultations, video and online consultations, home visits etc.
• Care related activities: These categories do not involve the patient but are about the patient; clinical tasks and activities undertaken on behalf of the patient.
• Administration and practice staff activities: These categories are for all activities and tasks required for managing a general practice and its staff.

The full list of categories is set out in the Annex.

Practices should ensure that national categories chosen are still relevant to their slot type generally and especially the four categories to show urgent same day appointments and eight categories mentioned in ACC-08.

As set out in Capacity and Access Improvement Payment (CAIP), the most appropriate appointment categories for use for urgent needs are:

• General Consultation Acute
• Unplanned clinical activity
• Walk-in
• Clinical triage

The eight categories that are within scope of ACC-08 are ones that patients will frequently want the first available appointment for. ACC-08 therefore includes appointments mapped to following national categories:

• General consultation acute
• General consultation routine
• Unplanned clinical activity
• Clinical triage
• Walk-in
• Home visit
• Care home visit
• Care related encounter but does not fit into any other category.

It is worth noting that the thresholds for ACC-08 reflect that not all these appointments would be expected to take place within 2 weeks. There will be cases where due to patient preference, or clinical advice, the period is longer. NHS England is working with IT system suppliers to implement exception categories reflecting this. For now, thresholds have been adjusted to take account of it.

Whilst there is an overall focus on improving appointment data recording, there are also several areas where practices and PCNs should pay particular focus, as set out below.

Use of triage category

All triage work should be allocated in appointment books as “clinical triage.” This is true whether the triage is undertaken by telephone, online consultation, or other mode.

Service setting

With the introduction of PCN delivery of enhanced access provision from 1 October 2022 several clarifications have been set out the standardised GP appointment categories guidance section on service setting.

Service setting 1 (General Practice) and 4 (Other) remain unchanged.

Service setting 2 (Primary Care Network) and 3 (Extended Access Provision) have been changed in terms of definition and additional clarification how these settings are to be used.

Service setting 2 (Primary Care Network) must be used for: 

• all appointments delivered either in practice or at a local PCN Hub by staff employed or engaged under the ARRS scheme working in core hours.
• all other appointments that are funded by the Network contract DES, (the only exception to this is for enhanced access appointments that are commissioned by the PCN, this includes ARRS sessions in the enhanced access period. For these appointments service setting 3 “Extended Access Provision” should be used.

Service setting 3 (Extended Access Provision) now refers to all Enhanced Access provision commissioned by PCNs.

Since the changes came into effect on 1 October 2022, Enhanced Access replaces both Extended Access and Extended Hours.

The table below sets out an Aide-mémoire for Service Setting:

Mode

Mode is the way in which the appointment was expected to take place and gives an indication of the scheduled and planned activity in general practice.

The full set of mode options displayed are:

• Face to face (home visit)
• Face to face (surgery)
• Not an appointment
• Telephone/audio
• Video with audio
• Written (including online)

New functionality is available to support recording of mode. The benefits will be:

• having a standardised method for recording the mode of an appointment will achieve more reliable reporting of appointment mode and help accurately understand the balance of care delivered in different ways as Modern General Practice is implemented.

A user should:

• on creation of an appointment slot or session of appointments, the users will see the appointment modes displayed within Status Type.
• The user will need to select from the single list of standardised mode options displayed. One of modes must be selected for every appointment. It is not possible to create a slot within the GP appointment module without selecting one of the mode options from within Status Type.
• The status type does not default to any value – users will need to proactively choose one of the standard national modes.
• No other mode options are available, and users are not able to add additional modes for selection. (If changes are required to the modes list in future, these should be signed off by NHS England who will request the update from the GP IT suppliers using well-established contractual routes).
• If the created slot is for something that is not an appointment the user can choose the “Not an appointment” option.
• Appointment Definition – before selecting the “not an appointment” option users should have regard to the agreed definition of an appointment [insert link].
• These status types are displayed when booking an appointment so if the user wants to change the mode when booking an appointment this can be done.

Support available

Support is available to practices and PCNs to improve the accuracy and quality of appointment recording.

GP appointments data hub

A central repository for GP appointments data (GPAD) containing the national publication, information on accessing your data through local and national dashboards, user guidance, and policies.

The hub has been created to support general practices, primary care networks and integrated care boards in improving the quality of their data so that it more accurately reflects the services they provide.

Dashboards

GPAD dashboards have been created to support practices, PCNs and ICBs. All dashboards will steadily be improved to support enhancing data quality and delivery towards the Primary Care Access Recovery Plan.

Details of each dashboard and how to access are accessible via these links:

• General practice GPAD dashboard
• Primary care network GPAD dashboard
• Integrated care board GPAD dashboard

For GPAD dashboard queries contact: contact the NHS England Contact Centre: enquiries@nhsdigital.nhs.uk 0300 303 5035.

Any queries regarding the published GPAD data: primarycare.domain@nhs.net

Product Implementation and Relationship Management team (PIRM)

PIRM supports practices and PCNs with any issues with the national categorisation of appointments.  If practices or PCNs would like any additional support or guidance around data recording or quality, then please contact the Product Implementation and Relationship Management (PIRM) team at pirm.office@nhs.net

Annex

Standardised set of national categories

Publication reference: PRN00668