Ruth Abrams is an organisational psychology and workforce researcher with an interest in the NHS workforce
In the first inquiry of its kind, cross-party think tank Policy Connect has published ‘First Point of Care: A Plan for a better NHS front door through Connected Primary Care’.1 This report examines four primary care sectors together including general practice, community pharmacy, dentistry and optometry, contributing to its novelty. Led by the All-Party Parliamentary Health Group, the report acknowledges primary care as the NHS’s front door; essential to access and equitable care. At the heart of the report is the fundamental question: What does access mean? The answer: access is about not only speed, but quality; whether a patient feels heard, understood, and experiences a satisfactory outcome.
…access is about not only speed, but quality; whether a patient feels heard, understood, and experiences a satisfactory outcome.
The report features five core findings. These include (1) that the current distribution of funding across the NHS system doesn’t follow need; (2) community pharmacy, dentistry and optometry services have weaker foundations than general practice; (3) that workforce skills are not being utilised to their full capacity; (4) community and other organisations outside the NHS are capable and indeed are already reaching people that primary care does not; and (5) that an increasing number of patients are giving up in trying to access primary care because they are turned away at the point of registration, or that they have to repeat their history at every point of interaction.
In a move likely to be welcomed by Government, thirteen recommendations focus on resource allocation within existing constraints. Instead of requests for additional funding, the report findings show how recommendations can be implemented mainly within existing resources and redeployment of funds or funded within existing resources. Recommendations span ideas including: establishing an access standard across all four sectors; improved access for underserved groups; open data standards; safe adoption frameworks for new technologies; expanded NHS App and website functionalities, alongside a non-digital route; reformed funding distribution; creation of an integrated commissioning framework; the enabling of community anchor institutions to support primary care; and the establishment of a primary care partnership architecture that consists of continuity of care as a core principle. Only three recommendations require additional funding and investment. Two of these three recommendations are workforce focused including the need to train, employ and retain the primary care workforce (recommendation 10); and to pair the neighbourhood health implementation with a workforce plan and a matching capital plan for the premises that workforce will need (recommendation 11).
Whilst the overall recommendations around resource utilisation are laudable, the workforce foci seek mainly to ensure the skillset of the current primary care workforce is utilised; and ensure buildings and the people are provided at the same time. Specifically, there is a heavy emphasis on making better use of existing skills, rather than on addressing workforce sustainability issues including wellbeing, burnout, skill development over time, new role implementation and talent development pipelines. Whilst the report rightly highlights that primary care access is constrained by underused professional expertise, access will not be secured solely by deploying staff more effectively.
A sustainable primary care front door relies on creating the conditions that enable staff to enter, remain and thrive within the workforce.
A sustainable primary care front door relies on creating the conditions that enable staff to enter, remain and thrive within the workforce. Therefore, access needs to be considered as a workforce experience, as well as a patient outcome. Alongside what access means, we also need to be asking, what does access require from the workforce that delivers it, and how can this be done within existing resources and funds? This is a significantly underexplored area in the report’s evidence base.
Contemporary understandings of access recognise the importance of continuity, care quality and patient outcomes.2 However, we have come to define access almost exclusively through the patient’s experience. Patients value being listened to, understood and cared for by professionals who know them. Those same relational aspects of care are frequently what make clinical work meaningful. Meaningful work (which includes human connection and professional autonomy) are key drivers of workforce retention.3 If these factors erode, access inevitably follows. However, until we ask what access means for the workforce as well as for patients, we risk treating access as symptoms of the workforce crisis rather than a potential cause.
References:
- Policy Connect. First Point of Care: A Plan for a Better NHS Front Door through Connected Primary Care. 2026. Available: https://policyconnect.org.uk/report/first-point-of-care-a-plan-for-a-better-nhs-front-door-through-connected-primary-care/
- Khan N. Access to general practice. Br J Gen Pract. 2025 May 2;75(754):220-221. doi: 10.3399/bjgp25X741465.
- Blustein DL, Lysova EI, Duffy RD. 2023. Understanding Decent Work and Meaningful Work. Annual Review of Organizational Psychology and Organizational Behavior 10:289-314. https://doi.org/10.1146/annurev-orgpsych-031921-024847
Featured photo by Luis Villasmil on Unsplash
