The changing landscape of UK general practice 2012-2025: continuity, care delivery, and satisfaction

Background

Over the past two decades, the UK’s National Health System has slipped from being top performing, with satisfaction falling among patients and clinicians. The Commonwealth Fund International Health Policy (IHP) surveys allow us to explore drivers of this decline, with a focus on general practice.

Methods

We descriptively analysed repeated cross-sectional data from the IHP surveys (2012–2025), capturing perspectives of primary care physicians, the general adult population, and older adults across 10 high-income countries.

Results

Continuity of care has declined sharply, with adults who have a single GP falling from 78% in 2013 to 58% in 2023, among the lowest internationally. For older adults this dropped from 92% to 72% between 2014 and 2024. At the same time, the organisation of care has shifted. GP practices are highly multidisciplinary, with near-universal hiring of nurses, pharmacists and other health professionals. Meanwhile, consultations are quick (around 12 minutes), with GPs and patients reporting low satisfaction with this. Remote consultations, which increased during COVID-19, have persisted: in 2025, 30% of consultations occur remotely, with high same-day access. Against this backdrop, GP experience has deteriorated. Satisfaction fell from 84% in 2012 to 56% in 2025, and stress is the highest relative to other countries in 2025. The loss of continuity of care is also felt by patients, with the share reporting that doctors know their important medical history dropping (89% in 2013 vs 64% in 2023).

Conclusions

A picture emerges of an under pressure system, changing in fundamental ways. UK general practice has adapted to be more digital, team-based, and access oriented, potentially at the cost of reduced continuity, high workload, and shorter consultations. These factors may explain why UK GPs are among the most dissatisfied internationally. Contrasting findings with that of other countries offers an opportunity for international learning.

Speakers/Panellists

Lorena Dini

Charité Univesitätsmedizin Berlin, Berlin, Germany