People across England continue to struggle to access primary care, with the same failures appearing across general practice, community pharmacy, NHS dentistry and optometry, according to a report by Policy Connect, a cross-party think tank.
The report titled "First Point of Care: A Plan for a better NHS front door through Connected Primary Care", examines why people in England struggle to access primary care and it examines all four primary care sectors together, recognising that patients do not experience general practice, community pharmacy, NHS dentistry and optometry as four separate systems.
The report, published on Wednesday (9), follows a cross-party inquiry led by the All-Party Parliamentary Health Group and chaired by Dr Simon Opher MP, Lord Kamall of Edmonton, Jess Brown-Fuller MP and Sadik Al-Hassan MP.
One of its findings is that funding is distributed in ways that do not follow need.
"Community pharmacy, NHS dentistry, and optometry have the weakest foundations. Clinicians are trained and then not commissioned to work."
Organisations outside the NHS are already reaching people primary care does not.
And the experiences that patients described matches what the inquiry found: registration failures, fragmented care, unmet need, and national measures that count only the people who were seen.
Resource allocation
The inquiry called for a fundamental shift in how NHS resources are allocated.
"Government should consider how best to deliver on its commitments to rebalance funding towards primary care and care closer to home, through the redeployment of existing NHS spending and away from acute hospital care."
They pointed out that primary care currently accounts for around 8% of NHS funding, compared with around 43% for acute hospital care.
The report sets out 13 practical recommendations for government to strengthen primary care and improve access.
- Establish a primary care access standard covering all four sectors and extend measurement to populations currently missing from access data.
- Improve primary care access for underserved populations, including by making inclusive registration standard practice.
- Preserve the local patient voice function and ensure it has a clear route into commissioning decisions.
- Mandate open data standards across primary care and the wider health and social care system.
- Establish a safe adoption framework for new technologies in primary care.
- Expand NHS App and NHS website functionality across all four sectors, alongside a guaranteed non-digital route.
- Establish a Primary Care Investment Standard and reform funding distribution in general practice and community pharmacy.
- Create an integrated commissioning framework across all four primary care sectors.
- Reform the primary care estates architecture and establish a capital investment programme when additional funding becomes available.
- Train, employ and retain the primary care workforce across all four sectors.
- Pair neighbourhood health implementation with a workforce plan and a matching capital plan.
- Enable community anchor institutions to complement existing primary care provision.
- Establish a primary care partnership architecture with continuity of care as a founding principle and a guaranteed primary care voice on every Integrated Care Board.
Sadik Al-Hassan said: “As Co-Chair of this inquiry, and having spent nearly two decades as a pharmacist, I have seen what primary care can achieve when the different parts of it are able to work together. This inquiry set out to understand how to make that the norm rather than exception.
"One of the most encouraging findings is how much capacity is already there. Pharmacists are qualifying as prescribers in growing numbers. Optometrists have equipment in their practices that can pick up disease early.
"In both cases the skills and the technology are in place, and what is missing is the route by which the NHS asks them to be used. What the report identifies is how to connect that capacity to the patients who need it, and there is real opportunity here for a Government looking to move care closer to home.
"I look forward to working with colleagues across the House to turn these recommendations into action.”
The inquiry collected evidence from across the health system, including professional bodies, patient organisations, academic institutions, NHS providers, and voluntary and community organisations.
