One of the questions Practice Index was asked by a practice manager recently related to staffing numbers and whether or not there was a formula for the correct number of staff to patients.
The honest answer is that there isn’t one, although we can look at statistical data to find out what the average staff:patient ratio is across GP practices, which should provide a ballpark figure to work to.
Various surveys and statistical analysis has been used to work out the staff:patient ratio in GP practices. One of the most recent of these (2014) was by the Centre for Workforce Intelligence, which found that there were approximately 2.5 GPs for every practice nurse.
It also broke down the percentage of practice paid staff by percentage, which found that the general practice team is made up of:
- 51.4% Admin staff
- 26.9% GPs
- 12.5% Practice nurses
- 7.5% Direct patient carers
- 1.7% others.
Another study, this time by The Health & Social Care Information Centre (HSCIC) in 2013, revealed that there is one full-time equivalent (FTE) nurse per 3,793 registered patients. Interestingly, that figure represented a 1.5% increase in the number of patients looked after by each nurse versus the year before.
Finally, an NHS Practice Management Network study discovered that there are:
- 1.36 FTE admin staff per 1,000 patients
- 0.45 FTE nursing staff per 1,000 patients
The variations in these figures show just how difficult it is to work out an accurate ratio. They do however provide crude figures to compare individual data against.
Practice Index has used the above stats to generate some crude examples of typical staffing levels at surgeries of different sizes (rounded to the nearest 0.25). The figures are as follows:
- GPs – 2
- Nurses – 0.75
- Admin staff – 3.25
- GPs – 4.5
- Nurses – 1.75
- Admin staff – 7.5
- GPs – 9.5
- Nurses – 3.75
- Admin staff – 16.25
Staff levels for telephone answering
With around 300 million consultations taking place each year in practices throughout the UK – and many involving multiple telephone calls to book the appointment – GP practices have to answer a lot of phone calls! Patients expect their calls to be answered and dealt with efficiently and, for safety reasons, it is important that the small number of patients who ring with an urgent need are answered promptly and appropriately. So how can practice managers work out how many members of staff they need to provide an efficient service?
There are a number of resources which practices could use to calculate the capacity required to ensure good telephone response. The Danish mathematician Agner Krarup Erlang – an expert in telephone systems – devised the standard formula used for calculating the maximum number of calls per hour that can be handled by a given number of agents (receptionists/call-handlers) given an average call length and the service level that is desired. The Primary Care Foundation looks into these calculations in more depth – click here to find links to some seriously interesting calculators and tools.
Working out the staff to patient ratio is a tough task that really varies from one practice to another. For example, according to the HSCIC nationally, the median consultation rate is 5.31 (so, on average, each patient is seen just over five times in the year) for doctors, nurses and other healthcare professionals within general practice. However, significant numbers of practices have consultation rates lower than four or higher than eight so there are very wide variations between practices.
As one practice manager told Practice Index, knowing practice capacity and how to best use available resources probably matters more. That’s something we’ll cover in a future post.