Health Matters

General Practice Is in Crisis — But Here’s Why I’m Still Optimistic

By Dr Imran | 16 June 2026 | Healthcare

I Want to Be Honest With You

General Practice in the United Kingdom is in crisis. Not a quiet, manageable crisis ticking along in the background — a real, urgent, systemic crisis affecting patient health, clinician wellbeing, and the long-term sustainability of the NHS.

I say this not to alarm you, and certainly not to despair. I say it because honesty is the first step toward meaningful change. And because, despite the pressures, the underfunding, and the impossible demand, I remain genuinely — and stubbornly — optimistic about the future of general practice.

Let me explain why.

The Reality We Cannot Ignore

Here is a statistic that still shocks me:

General Practice handles around 90% of all patient contact in the NHS in England — yet receives less than 10% of the NHS budget.

Read that again.
Ninety percent of the contact.
Less than ten percent of the funding.

The consequences are visible every day:

Patients struggling to get appointments
GPs carrying caseloads no clinician was designed to manage
Surgeries in deprived areas closing because they’re no longer financially viable
Young doctors choosing not to enter general practice because they can see the reality ahead

Having worked in NHS leadership roles for many years, I can say this with certainty: the underfunding of General Practice is one of the most consequential and least-discussed failures of healthcare policy in recent memory.

What It Feels Like on the Frontline

I still work as a GP. I still sit in that consulting room with the same list, the same pressures, and the same extraordinary breadth of human need presenting itself in appointments that are never quite long enough.

In a typical week, I might see:

A young mother with postnatal depression waiting months for mental health support
An elderly patient with multiple long-term conditions whose care is fragmented across several departments
A working professional who has ignored their health for years and is now frightened by what they’ve discovered
A child needing careful, unhurried assessment — while the waiting list outside grows longer

General practice asks you to hold all of this. To be expert across the full breadth of medicine. To be a coordinator, advocate, diagnostician, counsellor, gatekeeper, and human being — all at once, for person after person, day after day.

GPs are not struggling because they lack skill or dedication.
They are struggling because the system has not kept pace with the demand placed upon it.

This is not a personal failing. It is a structural one.

Why I Am Still Optimistic

And yet, every morning, I go to work with genuine belief that things can and will get better. Here’s why.

1. The People Are Extraordinary

The clinicians, nurses, pharmacists, receptionists, managers, and administrators working in general practice are among the most dedicated professionals I have ever known. They innovate constantly. They care deeply. They find ways to do more with less.

That level of commitment does not disappear. It is the foundation upon which improvement will be built.

2. The Conversations Are Changing

Public awareness of the pressures facing general practice is higher than ever. Patients increasingly understand that difficulty accessing appointments is not due to a lack of care — but a lack of capacity.

Public understanding creates political pressure.
Political pressure creates change.

3. Innovation Is Happening Everywhere

I see it in:

Surgeries piloting new multidisciplinary models
Technology supporting triage and reducing unnecessary appointments
Social prescribing connecting patients with community resources
GP partnerships reimagining sustainable practice models

General practice has always been innovative — necessity ensures it.

4. The Solutions Already Exist

This crisis is not a mystery without answers. We know what needs to happen:

Fairer funding
Genuine workforce investment
A shift toward prevention
Strategic, joined-up system-level thinking

The knowledge exists. What’s needed now is the will — and the leadership — to act.

What I Am Doing About It

Throughout my career, I have tried to be part of the solution rather than simply describing the problem.

That has meant:

Leading NHS transformation in Trafford
Contributing to the formation of Integrated Care Systems in Greater Manchester
Working with the Royal College of General Practitioners to recognise excellence
Developing the Reinforce Programme for General Practice, a practical framework helping surgeries strengthen themselves clinically, operationally, and financially

Because here is what I believe:
Individual surgeries do not have to wait for systemic change before they can thrive.

With the right support, frameworks, and leadership, GP practices can build resilience — even in a difficult environment.

That belief is not naïve. It is evidence-based. I have seen it work.

A Message to Patients

If you are reading this as a patient rather than a clinician, I want to say this directly:

Your GP is fighting for you.

The frustrations you feel about access and waiting times are shared — deeply — by the people on the other side of the consultation. We went into medicine because we want to help. The barriers between us are systemic, not personal.

The best thing you can do, beyond looking after your own health, is to add your voice to the growing call for a properly funded primary care system:

Talk to your local councillor
Write to your MP
Share this post
Tell others what general practice means to you

Because in the end, this is your NHS too.

In Closing

General practice is in crisis. That is true.

But it is also filled with extraordinary people doing extraordinary work. It is a sector that has survived underfunding, pandemics, and structural upheaval — and kept showing up. It is a profession that, at its best, offers something almost no other part of healthcare can: the experience of being known, truly known, by the person caring for you.

That is worth fighting for.

And I, for one, am not done fighting.

Dr Imran is a GP and Consultant Family Physician based in Manchester, UK. He has held multiple NHS Chair roles in transformation and strategic leadership and is the creator of the Reinforce Programme for General Practice.
If you are a GP partner or surgery looking for support, contact info@doctormimran.com for a free consultation.
Visit doctormimran.com to learn more.