The hidden workload study protocol: a national mixed-methods analysis of general practice workload and local demographics

Background General practice workload is increasing. Routinely reported NHS data describes workload in relation to numbers of appointments and clinicians delivering appointments. However, “hidden” aspects of general practice workload, such as administrative and supervisory tasks, are not measured.

Aims The Hidden Workload Study will examine the full range of tasks that general practice clinicians undertake daily and investigate how workload varies according to clinical role and practice demographics. Participants’ lived experience of workload will also be explored through interviews.

Design & setting Utilising the Primary Care Academic CollaboraTive’s membership and collaborative methodology, mixed quantitative and qualitative methods will be used. All clinicians working in English general practice, including general practitioners of all grades, resident doctors, nurses, physician associates, pharmacists and other allied healthcare professionals will be eligible, aiming for>500 participants across>75 practices.

Method Participants will collect data on a randomly allocated day in late 2024/early 2025. Using a data collection form and timers, participants will record their planned work schedule and then all tasks they complete, including all clinical, administrative, and supervisory tasks, and breaks. Practice demographic data will be collected from NHS Fingertips. For the qualitative arm, 15-20 semi-structured qualitative interviews will also be carried out. Quantitative data will be described according to clinical role and practice demographics, and interviews transcribed and reflexively analysed.

Conclusion The Hidden Workload Study will provide a comprehensive mixed methods analysis of contemporary general practice workload. Potential explanations for workload variations will be explored, informing future service provision and workforce planning.