I’ve been looking at practice data for years, especially triage and call figures across GP surgeries. I keep hearing the same thing: if we just had better data, we could finally fix the NHS.

But here’s the problem. Data doesn’t speak for itself. It gets interpreted, distorted, and misused. What gets measured often gets misunderstood.

Misunderstanding Starts at the Definition

Before you can measure anything, you need to know what you’re measuring and why. Misunderstandings begin the moment we skip this step.

Take the patient satisfaction survey. It shows a steady decline in satisfaction with general practice. But dig into it and you’ll see the survey includes anyone, regardless of whether they’ve even had contact with their GP. Is that what you picture when you hear about declining satisfaction?

The data might be technically accurate, but it doesn’t reflect reality in a meaningful way. Always ask: what’s being counted, and how is it defined?

Data Collection Has a Cost

Even when data is handed to you “for free”, there’s still a cost. Someone has to sift through it, question it, and interpret it. And often, collecting that data takes time away from patient care.

I’m regularly asked about the closure rates of triage GPs. That is, how many requests are resolved without an appointment. But I don’t track it. Why? Because collecting that data would slow us down, reduce flexibility, and most likely worsen care.

Just because you can measure something doesn’t mean you should.

When a Metric Becomes a Target

Once something is measured, it starts to matter. Sometimes more than it should.

Imagine you’re told to monitor how many triage requests you close without an appointment. Suddenly, those with high closure rates are being praised. The figures go into presentations. People start talking about the “top performers”.

At that point, the measure becomes a target. And behaviour shifts, often in ways that make care worse rather than better.

Data for the Overlords, Not the Coal Face

The people with the most power are often surrounded by data, yet disconnected from day-to-day practice. Those at the coal face, on the other hand, are rich in experience but poor in access to information.

Too often, data is created for those who don’t use it to care for patients. I’ve tried to change that. For example, I work with phone data across practices and present it in ways that my reception colleagues can actually use. Not to judge them. But to help them ask their own questions and spot patterns I wouldn’t notice.

Give people the autonomy and the tools and they will find the insights.

Data is Sterile

Data removes the colour from complex systems. It flattens messy, human experiences into neat rows on a spreadsheet.

If you act on those numbers without trying to put the colour back in, you risk making poor decisions. Numbers won’t tell you why something is happening. That takes conversations. That takes listening.

Without the colour, it’s just a number.

It’s Not a Machine

The NHS isn’t a factory. General practice isn’t a machine. We’re measuring human services, built on relationships and judgement.

With machines, data is straightforward. Engine temperature. Wheel rotations. No ambiguity.

Human activity is messy. Always has been. If data is presented to you like it describes something clean and mechanical, be sceptical. Ask where the mess is. If you can’t see it, something’s missing.

Data has its place. It can reveal. But used badly, it can distort, distract, and demoralise.

Be careful what you choose to measure. And never forget. What gets measured gets misunderstood, unless we start by asking better questions.

What Gets Measured Gets Misunderstood

I’ve been looking at practice data for years, especially triage and call figures across GP surgeries

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