Is general practice at a tipping point? Why rejuvenating general practice is a strategic imperative for the NHS

General practice has historically been lauded as the cornerstone of the NHS, recognised for its ability to provide registered lists of patents with accessible, cost-effective, continuity of care, free at the point of need. While this ethos remains, our new report, "Rejuvenating general practice: Ensuring a resilient future for primary care", explores how and why this cornerstone relationship has reached a critical tipping point. Our blog provides an overview of the challenges facing general practice including decreased levels of funding, unrelenting increases in the scale and complexity of demand, radical changes in the composition of the workforce, and deteriorating general practice estate. We explore the expectations for general practice in the government’s Fit for the Future: 10-Year Health Plan for England and the strategies needed to ensure that general practice remains a crucial driver of a resilient, productive, predictive, preventative and patient-centred healthcare service.

Our research comprised interviews and surveys (conducted from April to July) across a wide range of GPs, practice leaders and managers who shared their views, understanding and experience on the current state of general practice. In addition, we conducted an extensive literature review and drew on Deloitte’s experience in working across healthcare systems in the UK and internationally to better understand the challenges facing general practice and the wider primary care system and identify actionable solutions that could help bridge the gap between the reality today and ambition for tomorrow.

The pressures mounting on general practice

We found a primary care system grappling with:

• Insufficient funding: while general practice handles over 55 per cent of out-of-hospital patient consultations, they receive only 5.5 pence from every NHS pound (equating to only £112.50 per patient per annum); there has also been a real-time decline in investment, despite providing increasing numbers of consultations, since 2018-19. This financial constraint significantly impacts operational resilience, investment in innovation, and access to services.
• Escalating demand: general practice currently manages approximately 1.5 million appointments daily, a 22 per cent increase since the start of the pandemic; many of the additional appointments are being delivered by non-GP practitioners and patient satisfaction is at an all-time low.
• A beleaguered workforce: with14.4 per cent fewer qualified full-time general practitioners (GPs), a concerning 27% decline in GP partners, and 40 per cent of GPs anticipating leaving general practice within five years, the loss of experienced clinicians carries profound implications for patient care, staff morale and job satisfaction. struggling to meet rising and more complex patient needs,
• Substandard infrastructure: a third of general practice premises are deemed unfit for purpose, with 22 per cent built before 1948, with restricted capacity that hinders the adoption of modern healthcare delivery models.
• Disparities in digital technology adoption and their ability to integrate patient data: while digital transformation is recognised as essential, there's wide variation in digital maturity across practices with issues around trust, interoperability, cost, and bureaucracy continuing to impede the seamless adoption and integration of technology in clinical pathways.

While these factors collectively contribute to a challenging operational environment, fostering frustration and dissatisfaction among GPs, other practice staff and patients, our interviews and surveys revealed a degree of cautious optimism that general practice can be revived; indeed  GPs and other leaders views on the state of general practice in five years’ time were almost entirely positive, believing that general practice can and will survive and thrive (see Figure 1).

The 10 Year Health Plan and vision for neighbourhood health

In July 2025, as our fieldwork was ending, the government published it’s 10 Year Health Plan for England (the Plan) seen as a blueprint for recovery, reform and sustainability of the NHS. The Plan outlines an ambitious strategic direction, predicated upon three fundamental shifts: from hospital to community, analogue to digital, and treatment to prevention.

The Plan signifies a pivotal role for a revitalised general practice model that is multi-professional, integrated, accessible and provides continuity of care, using digital tools, technologies and insights from enhanced data utilisation. It sees general practice as pivotal to the development of a new ‘Neighbourhood Health Service’ in which care delivered closer to patients’ homes, tailored to the specific requirements of local populations. Integrated neighbourhood teams (INTs) will provide care using a diverse mix of talents from primary, community and acute settings, including flexible use of staff from other sectors where they are involved in a patient’s care.  INTs are expected to herald a “more simplified approach to collaboration and integration to overcome the traditional silos that have beset the NHS”. Revitalised general practice models are expected to be central to the establishment of INTs, combining the best of autonomous local primary care teams with the benefits of working at scale, to deliver more personalised predictive, preventative care.

While the Plan acknowledges the value of the traditional GP partnership model it proposes that this should move from small, independent, practices largely reacting to illness, towards larger-scale, digitally integrated practices focused on proactive population health management. It acknowledges that where the traditional GP partnership model is working well it should continue, but alternatives will be needed. The Plan advocates for better utilisation of community assets and flexible deployment of estates, including the co-location of services in high streets, pharmacies, and retail spaces, deploying AI-enabled technologies, to enhance accessibility and integrate health and wellbeing into daily life. It proposes that the required redesign will attract additional funding and, in finalising the 2025-26 contract, the government announced increased funding to general practice of £889 million a year, including increasing the global sum per weighted patient from £112.50 per patient in 2024 to £121.90 and £102 million for upgrades to 1,000 GP surgeries.

The evolving and pivotal Role of GPs in neighbourhood health

We used insights from our interviews and surveys, supplemented by findings from our literature review and experience working across healthcare, to identify a compendium of good practice examples of innovative and impactful solutions such as new ways of collaborative working, use of targeted, population health management and innovative adoption of AI-enabled digital technologies. We identified four key constraints (workforce, funding, digitalisation and data interoperability, and estates) that need to be addressed so that they become enablers for a resilient and sustainable general practice system.  We also identified actionable insights including suggestions for a future general practice model, six critical design principles for the future of digitalised and sustainable general practices and six actions to bridge the gap between current realities and future aspirations:

• Patient activation: GPs will be instrumental in empowering individuals to manage their own health through digital tools and personalised care plans, guiding patients to become proactive participants in their health journey.
• Embedding digitalisation and an integrated data ecosystem using AI: GPs will play a crucial role in leveraging AI-enabled technologies, the Single Patient Record (SPR), and the NHS App to streamline operations and enhance care coordination. This includes facilitating the adoption of these innovations by both staff and patients.
• Next-generation flexible workforce models: GPs are in an ideal position to contribute to developing multidisciplinary teams and addressing the drivers of job satisfaction, thereby aiding in the retention and attraction of talent within the primary care sector.
• Outcomes-based performance monitoring and aligned Incentives: GPs will be central to shifting focus from activity-based metrics to those that measure quality and patient outcomes, ensuring that funding models incentivise effective, patient-centred care.
• Sustainable, modernised estate: GPs will advocate for and participate in the investment in fit-for-purpose premises and the exploration of innovative models such as Neighbourhood Health Centres, optimising physical infrastructure for modern healthcare delivery.
• Proactive, preventative, health equity initiatives: GPs will continue to lead the paradigm shift towards preventative medicine, from screening and early diagnosis to providing guidance on healthy lifestyles. Their expertise will be vital in ensuring that prevention becomes a universal priority across all life stages, thereby addressing health inequalities through targeted interventions.

Conclusion

Rejuvenated general practices will remain critical to the revitalised NHS, with GPs seen as pivotal leaders and expert clinicians within a more integrated, digitally enabled, and community-focused healthcare system, thereby retaining its esteemed position as a cornerstone of the NHS. While significant challenges exist, there is a strong sense of optimism about the future of general practice which can only be reinforced by seizing the opportunities presented in the 10-Year Health Plan.

The last decade has proven GPs to be versatile, adaptable and ready to rise to the challenges ahead and have been digitalised for over 20 years. General practices also know their patients like no other service and are effective system integrators which will enable them to play a leading role in the development of the new neighbourhood health teams. Successful transformation hinges on embracing multi-year planning, data-driven decision-making, interoperability, adoption of  evidence based innovation and a multiprofessional approach to care, which, for the most part, should be delivered at-scale. It also requires general practices to take on a system leadership and collaboration role, underpinned by new operating and funding models, including transformation funding, alongside ongoing longer-term investment commensurate with the requirements envisioned for a rejuvenated general practice.