Policies to increase access to general practice may have unintended consequences

Strengthening primary care is central to the three shifts set out in the government's 10 year health plan for England: from hospital to community, sickness to prevention, and analogue to digital.New qualitative research captures the views of 70 patients, carers, and general practice staff across England and offers some cautions about the current direction of policy. 1 Although the three shifts present opportunities for improving services, they also risk fragmenting care, widening inequities, generating inefficiencies, and failing to deliver what many people value most in general practice: human connection and continuity with a general practitioner (GP) they know. 1 Recent efforts to improve general practice in England have consistently focused on increasing the speed and volume of access.Changes include increasing the size of the workforce by introducing new roles (eg, pharmacists, social prescribers, physician assistants), creating alternative routes to care, and requiring online consultation systems to remain open during core hours. 2 3Although these policies might improve access for some, they can also have unintended consequences.The changes risk eroding what makes primary care effective: being the first point of contact, coordinating care, delivering comprehensive generalist care, and, importantly, providing continuity of care.