Shaping the Future of Primary Care in the UK: Priorities and Challenges Over the Next Decade

Primary care in Britain is entering a steady but undeniable period of transformation. The pressures on the system are familiar: rising demand and new clinical complexity. The context around these pressures, however, is shifting. As the NHS prepares its 10-Year Plan, primary care is also adapting to new commissioning arrangements through Integrated Care Boards (ICBs) and a growing focus on the neighbourhood teams. Within this changing landscape, primary care is expected to act as a stabilising force of the wider system.

The roundtable on 8 October 2025, titled “Shaping the Future of Primary Care: Priorities and Challenges Over the Next Decade”, chaired by Dr. Sheikh Mateen Ellahi brought together general practitioners, community pharmacists, ICB leaders, digital leads, and voluntary sector partners for an insightful conversation that went beyond mere policy intentions and into the lived realities of care in the UK. The session repeatedly circled back to one tension: expectations of primary care continue to rise faster than its capacity to respond.

The need for this report is immediate. Recent national publications, including the NHS Long Term Workforce Plan, have set out ambitious directions for the future without fully resolving how those ambitions can be implemented locally. This roundtable was designed to help bridge that gap by grounding national intent in lived system experience - what is working, what is fragile, and what must be put in place to make prevention and digital-enabled access real across diverse settings.

A System Under Pressure

Pressure isn’t new in primary care - what feels different now is the number of reforms landing at once. With an overstretched workforce, services are being asked to take on more responsibility for prevention, earlier intervention, and wider system stability. The roundtable struck an optimistic note: neighbourhood care is taking shape, opening space for new preventative routes. But participants also stressed how uneven that shift remains. Differences in GP numbers, estate readiness, workforce capacity, and digital preparedness continue to determine where progress can be sustained, and where it is still fragile.

A Fragmented System?

Although the NHS is often described as a unified health system among high-income countries, delegates described operational fragmentation across primary care that limits shared planning and integrated delivery. Structural and contractual misalignments, alongside operational separation, reduce opportunities for workforce integration and digital connectivity, and can translate into duplication and gaps in continuity.

Participants also noted that neighbourhood and “at-scale” models are emerging, and that the direction of travel is toward better integration. Yet the pace of transformation remains uneven, reflecting differences in local capacity and infrastructure rather than a lack of intent.

An Essential Voluntary Sector

 

The discussion also emphasised the growing importance of Voluntary, Community, and Social Enterprise (VCSE) and faith organisations in delivering upstream prevention through social and behavioural interventions. Participants argued that the next phase is less about creating new protective frameworks and more about building trust: VCSE and faith partners should be treated as credible delivery organisations, capable of holding risk and delivering substantial contracts.

This requires more stable funding. Delegates highlighted that fragile voluntary partnerships often reflect inconsistent funding rather than organisational weakness, and that greater stability - potentially through more consistent, joint health-and-social-care funding - should be considered and protected.

Digital Transformation

Digital-enabled access is central to the direction of travel, but the roundtable cautioned that digital transformation could widen inequalities when implementation is uneven. A cohesive digital equity strategy is needed—one that recognises the different roles of primary care providers and supports interoperability across settings, including community pharmacy, without adding administrative burden.

Delegates also stressed that human connection remains essential. Digital systems should serve patients and practitioners, not replace the relational foundations that make prevention and continuity possible.

Key recommendations

·       Develop a Primary Care Integration Framework, aligned with the NHS Long-term Plan,

·       Stabilise funding for voluntary and community partners. Consider protected, joint health-and-social-care funding so VCSE organisations can plan, scale, and deliver with confidence,

·       Publish a clear digital equity strategy that supports different provider roles and delivers true interoperability across settings.

·       Make collaboration easier by backing “at-scale” federated GP models (and equivalents in other sectors) through aligned commissioning.

Looking Ahead

Primary care does not lack vision; it lacks stability to ensure this vision translates into reality. For every part of primary care to be recognised as interdependent, the next phase requires funding and aligned commissioning.

GPN’s series will continue to gather insights from frontline leaders to ensure reforms are grounded and that primary care is equipped to shape health outcomes before a crisis.

To stay informed and access future discussions, please visit and register at:

https://www.globalpolicynetwork.com/copy-of-middle-east-policy-series-1