General practice and primary care in Wales has reached a critical point, with “bold action” needed to ensure more services can be delivered closer to people’s homes, a Senedd Committee has said.
A new report by the Senedd’s Health and Social Care Committee warns that without more focus on primary and preventative care the NHS in Wales will continue to struggle to meet rising demand.
The Committee calls on the incoming Welsh Government to shift more services from secondary care into the community, making sure people have access to strong, well-resourced primary and preventative care earlier and more conveniently.
It stresses that this will require a carefully managed transition, with a commitment to double funding for a period of time.
Chair of the Senedd’s Health and Social Care Committee, Peter Fox MS, said:
“General practice and primary care are the cornerstone of our NHS. If we are to ease the growing pressures across the whole health system, we must shift towards prevention and ensure people can access services closer to home.
“This means investing in care that helps people stay well and receive treatment earlier in their communities, but doing so in a way that is safe, planned, and properly supported.
“Delivering a truly community focused model will require bold action, and we must restore patients’ trust in their local services. The message is clear, we cannot resolve the pressures in our hospitals unless we strengthen general practice and primary care.”
Unless the NHS prioritises prevention, demand will continue to outstrip capacity, the report warns. It argues that investing in general practice is one of the most effective ways to deliver preventative care, improve management of long-term conditions, and reduce avoidable hospital admissions. However, years of underinvestment and a declining GP workforce threaten progress, says the committee.
The funding formula used to allocate core funding to GP practices – the Carr-Hill model – no longer reflects the needs of the Welsh population, says the report. Some practices serving the most deprived communities receive significantly less funding despite higher levels of illness and greater demand.
The Committee warns that continuing with the current formula risks deepening inequalities and undermining the sustainability of general practice. It calls on the incoming Welsh Government to commit to reforming the formula, and publish the timescales for doing so.
The morning rush for appointments remains one of the biggest frustrations for the public. For older people this can prevent access to care, while young people find the system incompatible with work and caring responsibilities.
Lack of continuity, short appointment times and overwhelming demand also contribute to the negative public perception.
The Committee is calling on the incoming Welsh Government to strengthen access standards, reduce reliance on time-limited booking windows, and rebuild trust by restoring continuity and communication with patients.
Over the course of its inquiry, the Committee took evidence from GPs, practice nurses, practice managers and other health professionals, and from representative bodies such as the British Medical Association (BMA) and Royal College of General Practitioners (RCGP).
Dr Rowena Christmas MBE, Chair of RCGP Cymru Wales, said:
“This inquiry has been a valuable opportunity to consider how people experience general practice and what practical steps the government can take to support GPs to deliver meaningful continuity of care which works for our patients. It makes sense for the patient, the wider NHS and the taxpayer to invest in general practice.”
Dr Gareth Oelmann, chair of the BMA’s Welsh GP Committee, said:
“BMA Cymru Wales valued the opportunity to share the challenges facing general practice in Wales with the committee, and we welcome the publication of the report. We look forward to engaging constructively with the incoming Welsh Government to secure the long term sustainability of general practice and to help deliver the shared aims of our Save Our Surgeries campaign.”
The report’s key recommendations include:
- A phased shift of selected services into primary and community care, supported by a period of dual funding to ensure safety and continuity.
- A strengthened focus on prevention, with general practice at the centre.
- Urgent review of the GP funding formula (Carr Hill) with clear timelines for reform.
- Improved GP access standards, reducing reliance on the “8am scramble”.
- A national workforce plan to grow and retain the workforce.
