Actual duration data was first included in the April 2022 release with data from December 2021.
Actual duration is the length in minutes of the consultation that took place and is included for appointments with an attended status only.
This field is recorded differently depending on GP system supplier. This leads to variations in data quality which NHS England are continuing to work with system suppliers to address.
EMIS
EMIS record the actual duration as the time between the appointment being marked as started and the time the clinician records that the consultation as complete. It is recorded in the appointment workflow, where the practice can use functionality in EMIS that creates a “PatientInTime” and “PatientOutTime”.
The "PatientInTime" is when the slot status changed to one of (Send In, Quiet Send In, Telephone - Start Call or Video - Start Call). If a patient has multiple send in statuses against the same slot EMIS return the latest send in date/time.
The "PatientOutTime" is when the slot status changed to one of (Left, Visited, Telephone - Complete, Video - Complete). If the patient has multiple left statues against the same slot EMIS return the latest end date/time.
If a slot has a valid "PatientInTime" but no “PatientOutTime” event is recorded in EMIS, the extract will still record that slot as having been attended but will have no actual duration.
TPP (SystmOne)
TPP can record the start time as either when the consultation is started, when a clinician calls for a patient or when the appointment status is changed to ‘in progress’. The end time is recorded as when the appointment is marked as finished with the actual duration being the difference between these two times.
If the start and end time are the same then no actual duration will be recorded. If the end time has not been set then no actual duration will be recorded.
Cegedim (previously Vision)
The duration is updated using the status changes of each appointment slot. The first change of status is logged when the patient arrives, either using an automated check-in machine, which is connected to Cegedim, or is manually checked in by a receptionist.
The second status is logged in the Vision Consultation Manager by the Clinician who updates the status to ‘In Consultation’.
The third status is the end of the appointment when the clinician updates the status again to ‘Seen’.
The difference between the second and third status is then the duration of the appointment.
All appointments in Vision are linked to a consultation. If the consultation is not finished by marking the patient as ‘Seen’ this could result in long appointment durations which would be categorised as ‘Unknown / Data Quality Issue’.
It is also possible for a patient to not be checked in and bypass the workflow however the occurrence of this is thought to be minimal.
Other Information
For practices using the EMIS system it is not possible to record the actual duration of appointments with the appointment mode ‘Online / Video’, or ‘Home Visit’. For practices using the Babylon (GP at Hand) system it is not possible to record the actual duration of appointments with the appointment mode ‘Face to Face’. These appointments will therefore be counted within the ‘Unknown / Data Quality Issue’ category within this publication.
Any appointments with a null duration or a duration of less than 1 minute or greater than 60 minutes have been grouped into an ‘Unknown / Data Quality Issue’ category within this publication.