As the UK transitions into spring, the primary care landscape continues to be shaped by a complex mix of structural strain, evolving public health concerns, and ongoing policy reform. General practice remains at the centre of efforts to alleviate pressure across the broader NHS, but many of the systemic issues—understaffing, access inequity, infrastructure gaps—persist despite recent pledges of funding and reform.

This week’s developments underline the urgent need for sustained investment and innovation in general practice and community care. From an increase in antibiotic-resistant infections to challenges accessing hormone replacement therapy, and from political strategies centred on NHS revitalisation to a major overhaul of the GP contract for 2025/26, the themes are clear: the need for resilience, modernisation, and equity within primary care has never been greater.

Unseasonable Pressures: The NHS Faces an Extended ‘Winter’

Although winter has officially ended, NHS England continues to operate under conditions akin to those typically seen during the colder months. New data published for February 2025 highlights a deeply concerning picture: over 1,700 patients per day endured emergency department delays of more than 12 hours before being admitted. Additionally, more than 14% of hospital beds remained occupied by patients who were medically fit for discharge but could not leave due to insufficient social or community-based support.

Comparative analysis with health systems in countries such as Sweden and the Netherlands underscores the disparity. These nations have effectively managed seasonal demand through the integration of social care, investment in digital systems, and strategic expansion of out-of-hospital services. In contrast, the UK’s system, hindered by decades of underfunding and delayed infrastructure development, lacks the necessary agility and capacity to withstand ongoing pressures.

While NHS England has initiated a series of reforms aimed at improving flow and relieving pressure on acute services, the underlying issues—namely chronic staffing shortages, siloed care pathways, and limited community care availability—require long-term strategic correction.

Antibiotic-Resistant Gonorrhoea: A Mounting Public Health Threat

The UK Health Security Agency (UKHSA) has raised the alarm over the increasing prevalence of antibiotic-resistant gonorrhoea in England. Ceftriaxone, the current first-line treatment for gonorrhoea, is showing diminishing efficacy, with 42 confirmed cases of resistance since 2015—15 of which are classified as extensively drug-resistant.

This development poses significant risk to public health. Untreated gonorrhoea can cause complications such as pelvic inflammatory disease, ectopic pregnancy, infertility, and increased HIV transmission. The UKHSA emphasises the need for preventative measures, including consistent condom use and proactive sexual health screening, particularly given the asymptomatic nature of many cases.

Primary care settings must remain vigilant and well-equipped to facilitate early diagnosis and referral, while public health campaigns may need to intensify focus on the implications of antimicrobial resistance in sexually transmitted infections.

Political Realignments: NHS Reform as a Central Campaign Theme

With the Labour government seeking to maintain public support amidst a resurgence of Reform UK, Prime Minister Keir Starmer is intensifying efforts to deliver visible improvements within the NHS. In what is perceived as a direct response to mounting political pressure, the government has pledged an additional £26 billion investment in the NHS, focused heavily on reducing waiting times and enhancing diagnostic capacity.

Specific measures include a commitment to doubling the number of medical scanners and reducing administrative burdens, with Health Minister Wes Streeting affirming that systemic improvement is key to mitigating voter dissatisfaction in marginal and socioeconomically disadvantaged constituencies.

While the political messaging is strong, analysts have noted that the tangible benefits of such investment are unlikely to be felt in the short term. Healthcare leaders continue to highlight the need for workforce stabilisation, capital investment in primary care estates, and robust collaboration between NHS bodies and local authorities to secure meaningful, long-term transformation.

Scotland’s Enduring COVID-19 Legacy

In Scotland, the enduring impact of the COVID-19 pandemic continues to reverberate across both public services and the economy. The NHS faces record-breaking waiting lists, deteriorating cancer treatment targets, and growing pressure on accident and emergency departments. In education, schools report declining attainment and engagement, while behaviour-related concerns are rising.

Transport infrastructure remains underutilised, with commuting patterns altered by the widespread adoption of hybrid and remote working models. The hospitality sector, once a vital component of Scotland’s economy, has experienced widespread closures and reduced footfall. Meanwhile, the housing market has seen marked growth in demand for larger, suburban properties, driving up house prices.

The Scottish Government is attempting to mitigate these challenges through targeted investment programmes. However, public services remain stretched, and sustained efforts will be required to rebuild confidence and capacity, particularly within the NHS.

Hormone Replacement Therapy: Demand Surges Amidst Access Inequity

Across the UK, demand for hormone replacement therapy (HRT) continues to climb, fuelled by increased awareness of menopausal health and the long-term benefits of treatment. Yet many women still face considerable barriers to access, including regional disparities in prescribing practices, ongoing supply issues, and a lack of clinical confidence among some prescribers.

In London, HRT prescriptions have surged, but elsewhere patients report inconsistent availability and delays in treatment initiation. These access issues are not merely clinical; they are also socio-economic. Women experiencing unmanaged menopausal symptoms frequently report disruptions to employment, reduced earnings, and withdrawal from the workforce.

The Department of Health and Social Care has responded by pledging to reduce the cost of HRT and expanding training for GPs. The Women’s Health Strategy, published as a ten-year plan, also outlines ambitions to improve menopause support within primary care, including the introduction of “menopause hubs” and wider integration with occupational health services.

GP Workforce: Fewer Doctors, More Patients, Rising Stress

General practice is bearing the brunt of escalating patient demand with a shrinking workforce. As of January 2025, there are 1,116 fewer fully qualified, full-time equivalent GPs compared with September 2015. Meanwhile, patient registrations have risen by 17%, equating to an additional 319 patients per GP.

The British Medical Association has described the current workload as unsustainable, noting high levels of burnout and widespread reports of clinical fatigue. Recruitment and retention efforts have had limited success, and while the GP Fellowship Scheme and international recruitment campaigns have yielded some positive outcomes, these have not compensated for attrition due to early retirement or career changes.

Urgent action is being called for, not only in terms of expanding training places but also in improving job satisfaction and career progression opportunities within general practice.

Major Reforms Announced in the 2025/26 GP Contract

NHS England has confirmed substantial reforms to the GP contract for 2025/26, with an additional £889 million being invested across core funding and the Network Contract Directed Enhanced Service (DES). This represents the most significant financial uplift in general practice funding for over a decade.

The changes aim to support continuity of care, enhance secondary prevention, and simplify incentive schemes. A notable addition is the introduction of a new enhanced service for advice and guidance, designed to improve collaboration between primary and secondary care providers and reduce unnecessary hospital referrals.

Adjustments to the locum reimbursement scheme, reforms to the vaccinations and immunisations framework, and a more streamlined approach to contract management are also included. These measures align with broader health system goals: moving care closer to home, increasing efficiency, and leveraging digital innovation to reduce administrative burden.

Conclusion

This week’s developments offer a sobering view of the pressures currently facing UK primary care, but they also signal a growing political and institutional will to address them. Funding commitments and contract reforms provide a foundation for progress, yet the scale of the challenge—ranging from workforce attrition to antimicrobial resistance—demands careful, sustained policy execution.

As general practice continues to shoulder the responsibilities of prevention, triage, chronic disease management, and community coordination, ensuring the system is adequately supported, staffed, and equipped is paramount.

How General Practice Solutions Can Support Primary Care During These Pressures

At a time when general practice is facing unprecedented challenges—from workforce shortages and rising demand, to systemic change and public health crises—supporting practices in delivering safe, responsive, and sustainable care has never been more important. General Practice Solutions (GPS) works in close partnership with primary care organisations to bridge operational gaps and ease pressures on permanent teams.

We understand the demands being placed on GPs, practice managers, and wider clinical and non-clinical staff. That is why we offer tailored support services, including the provision of experienced interim staff to cover short- or long-term absences, unexpected capacity surges, or the need for additional resource during peak periods.

Whether practices require short-notice cover for reception and telephony teams, qualified coders, administrators, or clinical support staff, our flexible resourcing model ensures continuity of service and patient care. Our associates are familiar with primary care systems, adaptable to varied environments, and selected based on their reliability, professionalism, and understanding of the pressures unique to the sector.

In addition, GPS provides strategic advisory and back-office support, helping practices implement changes aligned with national priorities—such as digital transformation, contract compliance, and service optimisation—without adding to the burden of already stretched teams.

Click here to find out how GPS can support your organisation today!

Introducing Our Free Patient Recall Service

Alongside our ongoing support for interim staffing and operational resilience, General Practice Solutions is pleased to introduce a new, no-cost service designed to directly support practices in meeting Quality and Outcomes Framework (QOF) targets.

Responding to recent demand, we are offering a free Recall Service, developed in partnership with Hippo Labs, to help primary care organisations streamline their recall processes, improve patient engagement, and enhance population health outcomes. This limited-time offer is available to a select number of practices on a first-come, first-served basis.

The service focuses on increasing uptake for key interventions such as cervical screening, childhood immunisations, and chronic disease reviews (e.g. diabetes, asthma, hypertension), while significantly reducing administrative burden. It is designed to integrate seamlessly with your existing clinical systems, supporting your team in targeting hard-to-reach populations through intelligent, automated recall technology.

Whether you are a single GP practice, a Primary Care Network, or part of a federation or ICS, this service offers a practical way to improve health outcomes, drive QOF performance, and ease the strain on your administrative teams—all at no cost.

With mounting pressures and limited capacity across the system, managing recalls manually is no longer sustainable. This free solution is our way of helping practices respond to those pressures more effectively.

To express interest or learn more, please contact us at 020 8865 1942, or via [email protected]. Availability is limited.

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