People from across the capital have given their views on the future of primary care services in London, following a series of in-depth workshops held over the summer aimed at ensuring local services match people’s needs and aspirations.
More than 100 members of the public, as well as NHS staff and those working in social care services, gave their views on primary care services such as GP and dental care during the deliberative exercise. Extensive engagement was also carried out with people from traditionally underrepresented groups to ensure that their perspectives were listened to and included, and a report of the findings is published today.
As people across the country continue to take part in the biggest ever conversation about the future of the NHS to inform a new 10 Year Health Plan for England, this detailed new report provides an invaluable contribution to the national debate.
The public workshops examined people’s views in key areas, including initial access to healthcare services, triage and prioritisation, team-based working in healthcare and ‘onward and proactive’ primary care services.
NHS England London regional director Caroline Clarke said: “Delivering around 52 million GP appointments every year in London, primary care services must work effectively for everyone and a long-term, innovative approach is needed to build sustainable services to meet future demand.
“By taking part in this deliberative process, Londoners have told us what they want to see from primary care services and what’s important to them. They are helping to inform and shape how our services are planned and delivered, as well helping people better understand the way decisions on how services should be provided, are made.
“The findings from this deliberative engagement will feed straight in to the ongoing national 10 Year Health Plan engagement exercise and clearly set out the public support in London for the Government’s three proposed shifts to care in the community, improved digital capabilities and better prevention.”
Over the course of three all-day deliberative workshops, participants were provided with detailed information about primary care services in London and the potential for change and improvement. They were then invited to grapple with the benefits and potential downsides of these before co-producing a set of informed and considered expectations for NHS decision-makers.
Those taking part in the exercise said appointment booking should be more convenient, with reduced waiting times and more flexible options like remote consultations. They said the option to choose either remote or in-person appointments was important.
There was an expectation of consistency across the capital in key areas such as digital access, complemented by a ‘local services’ option to accommodate regional differences and preferences. Another strong message to come from the engagement process was an emphasis on empowering patients to navigate the balance between continuity of care and convenience by allowing them to make that choice themselves.
Investment in simple, easy-to-use, standardised digital access to services was seen as vital. AI was also seen as important, but it should be rigorously tested and evaluated.
Informed patient choice of where to go and who to see for treatment was identified, as well as the importance of considering travelling times and patient transport. There was also strong support for integrated neighbourhood teams, with access to shared data, and for these teams to be tested in more deprived areas of London.
Regional Medical Director for Primary Care at NHS England London Dr Agatha Nortley-Meshe said:
“This deliberative engagement provided invaluable insights to guide the future direction of primary care services in London
“The public sent a clear message about the importance of proactive care, particularly in addressing the needs of vulnerable populations and tackling health inequalities.
“It was also recognised that primary care cannot achieve this alone. Whole-system integration is essential, requiring collaboration across the wider NHS, local authority, schools, workplaces, faith groups, and third sector organisations – all of which have critical roles to play.
“While there was strong support for digital healthcare access, it must remain adaptable and inclusive, with alternative options to prevent digital exclusion.
“These insights will guide us in developing services that meet the hopes needs and expectations of London’s diverse communities.”
Co-chair of the London Primary Care Board and Chief Executive Officer of South East London Integrated Care System Andrew Bland said: “Primary care services face significant challenges on many fronts, making transformation essential. Involving the public meaningfully is crucial to shaping a service fit for the future.
“Deliberative engagement, which is an approach involving informed, in-depth discussions, has enabled the NHS in London to start these vital conversations with the people we serve, providing insights that will directly influence decision-making and the transformation of primary care.
“This report highlights the power of collaboration and offers a roadmap for change and improvement, inspiring action and encouraging ongoing dialogue between healthcare providers, policymakers, and the public.”
Victoria Grandon, who took part in the process, said: “I have been to a lot of meetings but have never been involved in something so well organised and managed. It was a great opportunity to gather a lot of information, hear from other Londoners and consider the challenge of how best to make changes to primary care in London”.
Dr Lisa Harrod-Rothwell, Deputy CEO of London-wide Local Medical Committees and London GP said: “We all want the best care for patients with efficient, sustainable use of resources. To achieve this, those closest to the knowledge – patients and their clinicians – must be empowered in the design of services. It is positive to see the public engagement prioritised through this deliberative process.
“The general practice and family doctor model of care has been shown to be highly effective for patient outcomes and healthcare system efficiencies, if resourced appropriately. Risks and benefits of proposed changes to this model must be understood; the deliberation process has offered members of the public with a valuable and constructive space to challenge certain assumptions and offer their key insights. I welcome further engagement with GPs and their patients regarding any proposals to change the role of the GP and the GP practice.”
The national public engagement exercise to help build a health service fit for the future continues, and everyone is encouraged to get involved. Visit www.change.nhs.uk to find out how you can contribute.
