1 Official statistics in Development

This report is published as Official Statistics in Development. Official statistics in development are official statistics that are undergoing a development; they may be new or existing statistics, and will be tested with users, in line with the standards of trustworthiness, quality, and value in the Code of Practice for Statistics. Until September 2023, they were called ‘experimental statistics’.

2 Executive Summary

  • The GP Headcount (excluding Specialist Trainees) decreased from 4,514 in 2022 to 4,474 in 2023, a decrease of 0.9%
  • GP whole time equivalent (excluding Specialist Trainees) decreased from 3,493.9 in 2022 to 3,478.4 in 2023, a decrease of 0.4%
  • The overall number of GP sessions lost to absence in 2022/23 was around 10,000 lower than in 2021/22. Sessions lost to sickness absence have increased by a similar amount but this may be influenced by a change in reporting categories since the 2021/22 survey.
  • GP practices in Scotland reported using 342 WTE Locums in 2022/23, the second highest number reported since this survey was first conducted in 2013.
  • The estimated nurse headcount was 2,437, a 1% increase on the previous year. Nurse whole time equivalent also increased by 0.8% to 1,702.4.
  • There was an overall reduction in estimated headcount and whole time equivalent for Health Care Assistants and Phlebotomists working in GP practices in Scotland. There were an estimated 442 Health Care Assistants in GP practices, equivalent to 288.1 WTE, and 84 Phlebotomists (45.9 WTE).

3 Introduction

This release by NHS Education for Scotland provides information on numbers of General Practitioners (GPs), Nurses and other General Practice staff in Scotland on 31 March 2023. We report headcount and Whole Time Equivalent (WTE) with breakdowns by age, sex and staff group.

The General Practice workforce survey was last carried out in 2022. Reports on previous versions of the survey were published by Public Health Scotland (PHS) and can be found on PHS’s website.

3.1 Data

3.1.1 Sample data weighting

The response to the survey was less than 100% and appropriate weighting has been applied to statistics calculated from the survey data to provide representative estimates at NHS Board and national levels. Statistics including headcounts, WTE, numbers of contracted hours and sessions, and numbers of vacancies are therefore survey-based, weighted estimates. This must be borne in mind when comparing some figures with previous survey reports, where weights may not have been applied to some statistics, with figures reported based on the survey sample data alone. Previous survey reports will be clear where weighted estimates have and have not been used. When consulting published tables, be aware that grand totals may sometimes differ slightly from the sum of values in a set of categories, depending on how weights have been calculated.

  • GP WTE, and contracted and vacant sessions, have been weighted using known GP headcounts in combinations of Board, designation, age group and sex.
  • Numbers of practices have been weighted using Board-level practice response rates to the survey.
  • WTE and contracted and vacant hours for all other staff have been weighted using known practice list sizes in each board.

3.1.2 Imputing missing data

For this year’s survey we have also addressed missing data using data imputation methods. Missing data on contracted and vacant hours, contracted GP sessions, and staff age have been imputed using a donor-based imputation that relies only on this year’s survey sample data for replacement values, and preserves existing relationships and distributions present in the sample data. These methods help to provide a more complete data set for analysis.

This report is accompanied by a series of data tables providing users with additional detail on the data collected in 2023.


3.1.3 Data quality

3.1.3.1 Vacancy length and status

There were quality concerns with the data on length of vacancies and vacancy status as at 31 March 2023. Many respondents supplied vacancy fill dates in the future, suggesting they may have supplied prospective start dates for new staff rather than the date of offer/acceptance as required by the survey. These dates often then did not align with the information on status of the vacancy on 31 March 2023. We will not be publishing data on length and status of vacancies at this time.

3.1.3.2 Vacancy rates

As described in the sections on GP, Nurse and other staff vacancies, the current methodology used to calculate numbers of vacancies and vacancy rates is likely to result in overestimation. Extra caution is advised when referring to the vacancy rates published here. NES will work with partners and users of these GP workforce statistics to further develop the data collection and analysis for vacancy information.

3.2 Response rates

The overall response rate for the survey was 80.7%, with data submitted from 730 practices. Table 1 presents the response rate for each NHS Board and is based on the number of practices eligible to respond to the survey in March 2023.

Table 1: 2023 Board-level response rates
Board Response rate
Ayrshire & Arran 83.3%
Borders 78.3%
Dumfries & Galloway 93.8%
Fife 77.4%
Forth Valley 88.0%
Grampian 84.1%
Greater Glasgow & Clyde 84.3%
Highland 64.1%
Lanarkshire 73.5%
Lothian 83.1%
Orkney 85.7%
Shetland 77.8%
Tayside 82.0%
Western Isles 88.9%
Total 80.7%

4 Results

4.1 General Practitioners

4.1.1 GP Headcount and WTE March 2023

The figures for GP headcount are sourced from the National Primary Care Clinicians Database (NPCCD, extracted July 2023) which is maintained by NHS Boards. Both the individual-level staff data from the survey and the GP data from NPCCD were filtered to include only staff who were in post on 31 March 2023. Specialist Trainees/Performer Registrars (medical practitioners in a GP training programme) were excluded from both the survey data collection and the data from NPCCD, and do not feature in this publication.

While the headcount figures for GPs are taken from NPCCD, their WTE is estimated using survey data on contracted sessions, where 1 WTE is defined as 8 contracted sessions per week. This data is then weighted using the known Board or NHS Scotland headcounts to give a representative estimate of WTE.

Information from 2012 to 2023 on GP headcount in Scotland, by NHS Board, GP designation, age and sex is available separately in the 2023 General Practitioner Headcount publication, also published by NHS Education for Scotland.

There were 4,474 GPs employed in General Practice on 31/03/2023, equivalent to 3,478.4 WTE. Table 2 presents for each Board the GP Headcount, estimated WTE, Average WTE and WTE per 10,000 patients.

Table 2: Headcount and estimated WTE for GPs in each Board
Board Headcount WTE Average WTE Headcount per 10,000 patients WTE per 10,000 patients
Ayrshire & Arran 294 229.9 78.2% 7.6 5.9
Borders 103 82.6 80.1% 8.5 6.8
Dumfries & Galloway 107 91.4 85.4% 6.9 5.9
Fife 276 213.7 77.4% 7.0 5.4
Forth Valley 236 178.1 75.5% 7.2 5.4
Grampian 455 350.1 77.0% 7.4 5.7
Greater Glasgow & Clyde 950 750.1 79.0% 7.0 5.5
Highland 369 299.1 81.0% 11.0 8.9
Lanarkshire 379 304.6 80.4% 5.4 4.3
Lothian 879 635.8 72.3% 8.6 6.2
Orkney 42 30.1 71.8% 18.9 13.5
Shetland 26 17.2 66.2% 11.3 7.5
Tayside 361 273.2 75.7% 8.2 6.2
Western Isles 31 22.5 72.7% 11.4 8.3
Total 4,474 3,478.4 77.7% 7.5 5.9

Doctors may work in more than one board, so the national total may not equal the sum of the Board totals.

4.1.2 GP Headcount and WTE 2013 - 2023

Figure 1 and Table 3 provide detail on the change in headcount and WTE over time. Table 3 includes percentage change in GP numbers, comparing the numbers from each year’s survey with results of the previous survey.

Table 3: GP Headcount and WTE 2013 - 2023
Year Headcount WTE Headcount % change WTE % change
2013 4,394 3,675.1
2015 4,410 3,603.7 0.4% -1.9%
2017 4,385 3,520.3 -0.6% -2.3%
2019 4,400 3,613.0 0.3% 2.6%
2022 4,514 3,493.9 2.6% -3.3%
2023 4,474 3,478.4 -0.9% -0.4%

Compared with the headcounts and WTE estimates reported in the 2022 survey, the number of GPs has decreased by -0.9% and GP WTE has decreased by -0.4%.

This time series is based on point-in-time reporting for each survey. The headcount and WTE estimates are based on the data from NPCCD reported at the time. As NPCCD is a live administrative database, with data being updated over time, some caution is advised in using these year-on-year comparisons.

4.1.3 GP Headcount and WTE comparison chart

Figure 2 presents the distribution of GP headcount and WTE over GP sex and age categories.

As with the 2022 survey, there were more female than male GPs in every age group under 60, and the difference between headcount and estimated WTE was larger for females in every age under 60. The demographic group with the largest headcount was female GPs aged 35 - 39.

4.1.4 GPs by designation

Table 4 presents headcount and WTE for GPs by GP designation.

Table 4: GP Headcount and WTE by Designation
Designation Headcount WTE Average WTE
Performer 3,196 2,623.9 82.1%
Performer Salaried 1,249 828.1 66.3%
Performer Retainee 51 26.3 51.6%
Total 4,474 3,478.4 77.7%

The largest designation by both headcount and WTE was Performer GPs; this group also had the highest average WTE.

Doctors may work as more than one designation, so the national headcount may not equal the sum of the designation totals.

4.1.5 Absences and Use of locum/sessional GP time

The following details on the percentage of practices reporting Locum use have been weighted using board-level practice response rates to allow representative estimates for all GP practices in Scotland.

Numbers of required and filled sessions, and Locum WTE, have been weighted using known GP headcounts in each board, consistent with the approach used for previous surveys.

The overall percentage of practices reporting Locum use was 86%, the same as in the previous survey. The total number of WTE Locums required was 415 and the total number of WTE Locum requirements filled was 342. This was an overall increase of 49.8 on the Locum WTE reported in the 2022 survey, although not all boards reported an increase. Table 5 presents Locum requirements and Locum use in each Board.

Table 5: Estimated Locum/Sessional GP WTE, April 2022 - March 2023
Board Practices using Locum WTE Locums required WTE Locums filled
Ayrshire & Arran 82% 17 13
Borders 78% 6 5
Dumfries & Galloway 87% 19 14
Fife 83% 30 17
Forth Valley 86% 17 15
Grampian 93% 50 43
Greater Glasgow & Clyde 87% 97 87
Highland 76% 32 27
Lanarkshire 88% 49 40
Lothian 92% 61 51
Orkney 83% 5 5
Shetland 100% 15 15
Tayside 88% 23 13
Western Isles 75% 5 5
Total 86% 415 342

Numbers of WTE locums have varied considerably over time. Referring to previously published reports for this survey since 2013, there were 290 WTE locums in 2013, 350 in 2015, 333 in 2017, 273 in 2019, and 292 in 2019.

4.1.6 GP absence

Table 6 presents estimated numbers of GP sessions affected by absence, by reason for absence. Numbers of sessions lost to absence have been weighted using known GP headcounts.

Table 6: Estimated absent GP sessions by reason, April 2022 - March 2023
Sick leave Maternity/Paternity leave Parental leave Special leave
Total 37,099 37,882 559 2,586

Overall sessions lost to absence are around 10,000 lower than was reported in the 2022 survey, but the changing impact of the pandemic and the inclusion of a self-isolation category in 2022 make it difficult to assess relative changes in absence over time. This may particularly be the case with sick leave, which has seen an increase of almost 10,000 sessions between 2022 and 2023. Absent sessions due to maternity/paternity leave increased between the 2022 and 2023 surveys by around 2,000 sessions.

4.1.7 GP vacancies

4.1.7.1 Note on interpretation

The following analyses (Table 7) are based on vacancies reported throughout the year April 2022 - March 2023. Vacancy rate is defined as the number of vacant weekly GP sessions over the year, divided by the sum of vacant sessions over the year and weekly sessional commitment of GPs in post in March 2023. This definition differs from the vacancy rates reported elsewhere in NES’s workforce statistics and may tend to overestimate vacancy rates, particularly in smaller boards. Extra caution is therefore advised when referring to the vacancy rates published here. NES will work with partners and users of these GP workforce statistics to further develop the data collection and analysis for vacancy information, in line with the development of this publication towards Official Statistics status.

Numbers of practices reporting GP vacancies have been weighted using Board-level practice response rates to provide representative estimates for all GP practices in Scotland. Numbers of vacant and contracted sessions have been weighted using Board-level GP headcount weights. This approach differs from previous years when only data form responding practices have been reported, so care should be taken when comparing figures over time.

Table 7: GP vacancies in NHS Boards April 2022 - March 2023
Board % of practices with vacancies Vacant GP sessions Contracted GP sessions Vacancy rate
Ayrshire & Arran 33.3% 140.8 1839.4 7.1
Borders 34.8% 64.7 660.4 8.9
Dumfries & Galloway 34.4% 138.8 731.3 16.0
Fife 60.4% 261.0 1709.4 13.2
Forth Valley 34.0% 130.5 1424.5 8.4
Grampian 63.8% 517.7 2801.1 15.6
Greater Glasgow & Clyde 30.4% 608.5 6001.0 9.2
Highland 30.4% 297.0 2392.5 11.0
Lanarkshire 38.8% 351.1 2436.5 12.6
Lothian 58.5% 655.7 5086.2 11.4
Orkney 57.1% 166.9 241.2 40.9
Shetland 55.6% 111.8 137.7 44.8
Tayside 54.1% 354.4 2185.4 14.0
Western Isles 66.7% 84.9 180.3 32.0
Total 42.3% 3813.0 27826.9 12.1

As discussed above, the island Boards have particularly high vacancy rates and this is unlikely to be an accurate reflection of the current staffing situation in these boards. Orkney’s vacancy data included several high-session vacancies for a practice with six island branch surgeries, all of which were noted as having been filled during 2023. Shetland and Western Isles also reported relatively high numbers of vacant sessions over the year April 2022 - March 2023 compared with the total employed sessions in March 2023.

4.2 Nurses

4.2.1 Nurse headcount and WTE March 2023

Headcount and WTE for nurses are estimates based on weighting the data in the survey by Board practice list sizes, to produce representative estimates for NHS Boards and Scotland.

There were 2,437 nurses in post in GP practices on 31 March 2023, equivalent to 1,702.4 WTE. Table 8 has details for each Board.

Table 8: Nurse Headcount and WTE by Board
Board Headcount WTE
Ayrshire & Arran 160 127.7
Borders 61 43.4
Dumfries & Galloway 84 59.1
Fife 173 125.8
Forth Valley 120 81.5
Grampian 369 249.5
Greater Glasgow & Clyde 391 271.2
Highland 204 129.6
Lanarkshire 239 177.6
Lothian 343 238.3
Orkney 25 17.3
Shetland 40 18.0
Tayside 196 142.6
Western Isles 26 20.8
Total 2,437 1,702.4

The Board and national totals have been calculated separately, so the national headcount may differ from the sum of Board headcounts.

These figures indicate a 1% increase in nurse headcount and a 0.8% increase in WTE since the 2022 survey. Figure 3 and Table 9 present numbers of nurses over time.

Table 9: Nurse Headcount and WTE 2013 - 2023
Year Headcount WTE Headcount % change WTE % change
2013 2,125 1,420.0
2015 2,175 1,455.0 2.4% 2.5%
2017 2,297 1,541.0 5.6% 5.9%
2019 2,465 1,690.0 7.3% 9.7%
2022 2,414 1,689.5 -2.1% 0.0%
2023 2,437 1,702.4 1.0% 0.8%

Figure 4 presents Nurse headcounts and WTE by designation.

The largest group was General Practice Nurses who accounted for 62% of the total headcount and 59% of the total WTE. The next largest group was Advanced Nurse Practitioners, accounting for for 28% of the total headcount and 33% of the total WTE.

4.2.2 Nurse headcount by role and age group

Figure 5 displays estimated headcounts of nurses grouped into two designation categories. Headcounts have been weighted as described above to produce representative national estimates.

Among Advanced Nurse Practitioners, the largest headcount was in the 50-54 age group. Among all other nursing roles, the the largest headcount was in the 55-59 age group.

4.2.3 Nurse part-time working

Figure 6 indicates that there was considerable variation among Nursing roles in terms of contracted hours. 63% of Advanced Nurse Practitioners were contracted for 30 or more hours per week, compared with 33% of General Practices Nurses. Treatment Room Nurses, General Practice Nurses and Senior General Practice Nurses were most likely to be contracted for 16-29 hours per week.

4.2.4 Nurse vacancies

Please refer to the guidance in the Data Quality section, and the note on interpretation in the GP vacancies section, which describe the methodology for reporting vacancies from this survey and the necessary caution when using the figures presented in Table 10

Table 10: Nurse vacancies April 2022 - March 2023
Board % of practices with vacancies Vacant hours Contracted hours Vacancy rate
Ayrshire & Arran 31.5% 547.5 4,724.3 10.4
Borders 17.4% 95.6 1,604.9 5.6
Dumfries & Galloway 28.1% 247.2 2,188.2 10.1
Fife 34.0% 603.4 4,653.2 11.5
Forth Valley 20.0% 391.0 3,016.2 11.5
Grampian 44.9% 1,449.9 9,233.4 13.6
Greater Glasgow & Clyde 19.6% 1,142.8 10,033.4 10.2
Highland 23.9% 593.0 4,796.3 11.0
Lanarkshire 35.7% 1,735.8 6,570.6 20.9
Lothian 31.4% 1,391.0 8,818.7 13.6
Orkney 57.1% 256.0 638.6 28.6
Shetland 666.0
Tayside 32.8% 600.6 5,275.6 10.2
Western Isles 11.1% 39.0 768.1 4.8
Total 27.8% 9,042.3 62,987.6 12.6

There were an estimated 9,042.3 vacant Nurse hours during 2022/23, equivalent to a national vacancy rate of 12.6.

4.3 Health Care Assistants and Phlebotomists

4.3.1 Headcount and WTE

Headcount and WTE for Health Care Assistants and Phlebotomists (Table 11) are estimates based on weighting the data in the survey by Board practice list sizes, to produce representative estimates for NHS Boards and Scotland.

Table 11: Health Care Assistant and Phlebotomist Headcount and WTE
Board Staff role Headcount WTE
Ayrshire & Arran Health Care Assistant 27 20.0
Ayrshire & Arran Phlebotomist 2 1.6
Borders Health Care Assistant 18 11.8
Borders Phlebotomist 4 3.5
Dumfries & Galloway Health Care Assistant 11 6.5
Dumfries & Galloway Phlebotomist 2 0.9
Fife Health Care Assistant 14 8.9
Fife Phlebotomist 3 3.1
Forth Valley Health Care Assistant 18 11.7
Forth Valley Phlebotomist 4 2.0
Grampian Health Care Assistant 24 10.4
Grampian Phlebotomist 1 0.5
Greater Glasgow & Clyde Health Care Assistant 84 58.1
Greater Glasgow & Clyde Phlebotomist 5 3.7
Highland Health Care Assistant 73 44.3
Highland Phlebotomist 2 1.5
Lanarkshire Health Care Assistant 13 7.9
Lanarkshire Phlebotomist 3 2.7
Lothian Health Care Assistant 92 67.4
Lothian Phlebotomist 48 23.3
Orkney Health Care Assistant 4 2.3
Shetland Health Care Assistant 10 4.7
Tayside Health Care Assistant 43 31.3
Tayside Phlebotomist 6 3.0
Western Isles Health Care Assistant 5 2.8
Total Health Care Assistant 442 288.1
Total Phlebotomist 84 45.9

There was an overall reduction in staff numbers for these staff roles since the 2022 survey: headcount decreased by 56 and WTE decreased by 42.7. The reduction was not uniform across all Boards. Larger reductions are reported for NHS Dumfries and Galloway, NHS Fife and NHS Western Isles, while some boards reported increases.

4.3.2 Vacancies

Please refer to the guidance in the Data Quality section, and the note on interpretation in the GP vacancies section, which describe the methodology for reporting vacancies from this survey and the necessary caution when using the figures presented in Table 12

Table 12: Health Care Assistant and Phlebotomist vacancies April 2022 - March 2023
Board % of practices with vacancies Vacant hours Contracted hours Vacancy rate
Ayrshire & Arran 1.9% 0.0 800.4 0.0
Borders
Dumfries & Galloway
Fife
Forth Valley 2.0% 35.3 503.5 6.6
Grampian 2.9% 118.7 403.6 22.7
Greater Glasgow & Clyde 3.0% 170.1 2289.2 6.9
Highland 9.8% 192.3 1692.1 10.2
Lanarkshire
Lothian 11.0% 331.2 3356.6 9.0
Orkney
Shetland
Tayside
Western Isles
Total 3.6% 830.1 12118.9 6.4

There were an estimated 830 vacant hours for these roles throughout the year ending 31 March 2023, with a national vacancy rate of 6.4%