The World of Politics

POLICY BANK RECOMMENDATIONS

NHS Primary Care Capacity Expansion

Policy idea
Mandate a significant expansion of NHS primary care capacity through extended opening hours, digital access and performance-linked funding to improve access, reduce pressure on emergency care and boost preventive health outcomes.

Problem this addresses

• GP access is often limited, especially outside standard weekday hours.
• Patients default to emergency or urgent care when primary routes are blocked.
• Population health needs are rising without a proportional increase in primary care capacity.

Proposal

• Require GP surgeries and primary care facilities to offer extended hours, including Saturdays and Sundays.
• Standardise digital booking and expand online triage/initial consultations via the official NHS app.
• Tie a portion of primary care funding to access performance metrics.

Why this matters

• Reduces pressure on A&E and urgent care by giving patients a viable first port of call.
• Improves continuity of care and early intervention for chronic conditions.
• Helps equalise access across regions where GP availability is currently uneven. TwoP

Estimated cost and savings

• Additional operating hours could cost billions initially, but long-term savings are expected from reduced emergency admissions and more efficient workforce use.
• Remote consultation and digital systems are anticipated to reduce demand for in-person appointments over time. TwoP

Implementation / next steps

• Draft legislation or NHS England mandate on minimum opening standards.
• Define performance indicators and adjust funding formulas accordingly.
• Pilot expanded hours in regions with the highest unmet need before national rollout.

Barriers / trade-offs

• Extending hours requires more workforce — training, recruitment and funding.
• Primary care workforce shortages mean near-term capacity gains may depend on recruiting foreign-trained staff or task shifting to allied health professionals. TwoP
• Extended hours could strain budgets without clear evidence of reduced downstream costs.

Context
Pressure on the NHS is perennial and concentrated where access bottlenecks occur. Labour’s 2025 “Neighbourhood Health Service” vision (PDF here) signals intent to reorient resources toward local primary care, but implementation details and funding remain unclear.

Sources and further reading
The Labour 2024 manifesto has many aspirations for the NHS.
In contrast the Conservative manifesto did not make many detailed proposals for the NHS but (pp40-42) proposed expanding the Pharmacy First initiative, building 250 GP surgeries and 50 more Community Diagnostic Centre – Conservative Party Manifesto, 2024
Prof Lord Ara Darzi’s Independent Investigation of the NHS, September 2024
The King’s Fund produced a report, Primary Care in a Nutshell, King’s Fund, April 2024

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