NHS reform ambitions ‘at risk’ without stronger general practice, warns RCGP

Governments across the UK risk falling short of their ambitions to transform healthcare without greater investment in general practice, the Royal College of GPs (RCGP) is warning today as it launches its first annual State of General Practice report.

The College is sounding the alarm ahead of the Budget on Wednesday and its Annual Conference in Glasgow later this week.

One key recommendation from the report, directed at the Chancellor, is to introduce a Primary Care Investment Standard to ensure that investment in general practice increases as a proportion of NHS spending and is transparently tracked over time. This would support practices with the resources to meet patient needs and to deliver the shift of care into communities.

The landmark report – the first of its kind for the RCGP - examines the pressures facing GP services across the UK and what needs to change to ensure patients receive high-quality care in the future.

Currently, general practice in England receives the lowest share of the NHS budget in a decade – around 8.3% - yet workload is escalating. In the year up to August 2026, GPs and their teams delivered 388 million appointments, an increase of approximately 91 million (31%) compared with the year to August 2019. Care has also increased in complexity as more people live longer and with multiple, chronic conditions.

At the same time, whilst numbers of qualified, full-time equivalent GPs have started to increase, they have not risen in step with demand. There are currently 29,400 fully-qualified full-time equivalent GPs, just 36 more than in September 2015.

The numbers of patients that GPs are responsible for has also risen over the same period. A qualified, full-time equivalent GP in England is now responsible for an average of 2,143 patients, an increase of around 11% - or 205 patients - since September 2015. These patterns are reflected in other parts of the UK, with an increase of 5.9% in patients per GP in Scotland since 2019, and an increase of 0.4% in Wales since 2021.

The State of General Practice report draws on findings from the RCGP’s recent survey of more than 1,500 members across the UK. Key findings include:

• Only 36% of GPs agree they have enough time to build the patient relationships they need to deliver quality care during appointments, with pressure to see patients as quickly as possible identified as the biggest barrier to providing greater continuity of care.
• Seven in ten GPs report not having enough time to offer preventive advice to patients.
• More than 1 in 5 GPs report feeling so stressed that they cannot cope most days or every day, which is double the findings from last year (22% vs. 11%).
• Only 36% of GPs surveyed in England agree that GPs in their area play a key role in designing neighbourhood services, despite plans to move more care into communities.
• More than a third of GPs report that Wi-Fi quality is not fit for purpose within their practices.

Against this backdrop, the RCGP’s State of General Practice report considers three ambitions that are shared by governments across the four nations: moving more care out of hospitals and into communities, making better use of digital technology, and placing greater emphasis on preventing illness rather than treating it.

The College concludes that all three will be difficult to deliver without the workforce, funding and infrastructure to support them. It says general practice should not be judged simply by the number of appointments being delivered, but by the quality of care patients receive and its contribution to the wider health and care system.

To ensure general practice has the means to support UK governments’ ambitions, the College makes a series of recommendations to governments and health systems across the UK, including:

• Strengthening the role of general practice, recognising the value of expert medical generalism and continuity of care, giving GPs a greater role in shaping neighbourhood and community services, and ensuring investment follows ambitions for reform.
• Expanding and retaining the GP workforce, by tackling workload pressures, supporting more rewarding careers in general practice and improving support for international medical graduates and academic career pathways.
• Improving digital infrastructure, including better links between digital systems and ensuring new technology is introduced safely and based on evidence.
• Supporting fair and sustainable general practice, with resources distributed equitably, greater support for prevention and investment in modern, fit-for-purpose premises.

Professor Victoria Tzortziou Brown, President of the Royal College of GPs, who will address delegates at the College’s conference on Thursday, said: "Across the UK, governments want to see more care delivered in communities, greater use of technology and more focus on preventing illness. These are all ambitions we support, but our report shows just how much needs to change if general practice is going to deliver them.

"GPs and our teams are already working under enormous pressure and it's concerning that only around a third feel they have enough time to properly assess and treat their patients. So much political focus is on speedy access, it overlooks important aspects of care such as continuity, which many patients – especially those with complex conditions – really value, and which we know is beneficial for the wider NHS.

“We know that many GPs want to do more to help patients stay well, but that takes time. If we're serious about prevention and providing more care closer to home, we need enough GPs and the resources to support them.

"General practice has a huge amount to offer, particularly the expertise of GPs and the relationships they build with patients over time. We need to ensure these strengths are recognised as services change. Our report sets out what needs to happen to give general practice the support it needs to deliver high-quality care and play its full part in the future of the NHS."

ENDS

Further information

RCGP press office: 0203 188 7659

press@rcgp.org.uk

Notes to editors

The State of General Practice 2026 is the RCGP's first annual report examining general practice across England, Scotland, Wales and Northern Ireland. 

Yonder Consulting was commissioned by RGGP to deliver the GP Voice Survey 2026. They survey was in the field between 4 and 31 August 2026, and it received a total of 1,524 responses from across the UK. 

Responses were weighted to the most recent official GP workforce statistics for each nation.