Healthcare associations write to Wes Streeting, urging sustainable investment in primary care

Sustainable investment in primary care services is crucial to alleviate pressure on other parts of the NHS

The Independent Pharmacies Association (IPA), in collaboration with the Association of Optometrists (AOP), the British Dental Association (BDA) and the NHS Confederation has written to health secretary Wes Streeting, urging him to ensure sustainable investment in primary care to strengthen the NHS and better serve patients.

In their letter, the group congratulated Streeting on his recent appointment as Secretary of State for Health and Social Care and requested a meeting to provide their joint constructive input towards improving health outcomes.

They expressed concern that recent administrations have failed to follow through on promises to properly integrate and fund primary care, leading to deteriorating health outcomes.

“Our collective experience is that our National Health Service (NHS), and health outcomes generally, have suffered at the hands of recent administrations that have talked much about the importance of properly integrating and funding primary care but not followed through with action,” they wrote.

The associations emphasised the need to transition the NHS to a Neighbourhood Health Service, where more care is delivered within local communities to identify  problems earlier.

“To achieve this, we must over time shift resources to primary care and community services,” they stated.

The letter highlighted that sustainable investment in primary healthcare services is crucial to alleviating pressure on other parts of the NHS.

“High-quality primary healthcare is the foundation of a sustainable and effective healthcare system,” they noted, pointing out that countries with good primary care tend to have lower health costs.

They expressed their belief that primary healthcare services, working together, can improve health outcomes and reduce the burden on hospitals.

The group observed that despite increasing demand and repeated official statements on the importance of primary healthcare, the proportion of spending focussed on primary healthcare has continuously fallen.

In 2021/22, primary care received only £14.9 billion compared to £83.1 billion for acute hospitals.

They argued that pharmacists, GPs, and dentists have been asked to take on more responsibilities without the necessary sustainable funding.

Furthermore, the associations raised concerns about the unsustainable pressure and unmanageable workloads faced by GPs, exacerbated by hospital waiting lists.

Practices are being forced to consider cutting back on services due to rising demand and real-term funding cuts, they noted.

In an effort to relieve pressure on GPs, the previous government launched the Pharmacy First Scheme earlier this year.

However, this initiative has resulted in increased financial and workload pressures for pharmacists due to insufficient sustainable funding, they said.

“In addition, a ‘broken’ reimbursement system, medicine supply shortages, and a funding shortfall have left many pharmacists facing debt and the prospect of closure,” the letter said.

The letter also highlighted that dentists are grappling with chronic underinvestment and the current NHS Dental contract is “not fit for purpose.”

They argued that this contract imposes a cap on the number of procedures for which dentists are reimbursed annually.

Unable to cover their operating costs, some dentists have stopped accepting NHS patients, which has increased the burden on hospitals as more patients seek treatment for tooth decay, they mentioned in the letter.

Additionally, they suggested expanding prescribing powers for all optometrists by revising the "entry-level exemptions" list of medications.

“Optometrists are already providing additional eye care services to cut the 600,000-long ophthalmology waiting list and to reduce pressure on GPs and A&E services. But optometry can do more.

“Widening the prescribing powers of all optometrists by revising a decades-old ‘entry level exemptions’ list of medications will enable optometry to create capacity for millions of GP appointments,” they wrote.

They emphasised that, as the front door to the NHS, primary healthcare services are best placed to understand and address local healthcare needs, but the system is not set up in a way to secure maximum benefit from these services.

“With sustainable support we can help realise Labour’s mission to build an NHS fit for the future,” they noted.

The letter was signed by Dr. Leyla Hannbeck, CEO of the Independent Pharmacies Association; Professor Aruna Garcea, Chair of the Primary Care Network at the NHS Confederation; Dr. Eddie Crouch, Chair of the British Dental Association; and Carolyn Ruston, Director of Policy at the Association of Optometrists.