15
min read

🩺 An overview of NHS Primary Care

A breakdown of what the NHS primary care structure, current needs and future direction.

Demystifying NHS Primary Care for HealthTech Innovators: A Deep Dive with Dr. Faris Al-Ramadani

Introduction: The Realities of Building in Primary Care

With the NHS under unprecedented pressure and healthcare innovators increasingly looking to primary care as a launchpad, understanding the inner workings of this vital pillar of the UK healthcare system is more essential than ever.

In this one-hour live session, Dr. Faris Al-Ramadani — GP partner, former PCN Clinical Director, and digital health consultant — joined Dr. Derrick Khor to unravel the complex structures, opportunities, and challenges within NHS primary care. The goal? To arm healthtech founders with the real-world knowledge necessary to design, position, and implement solutions that primary care actually needs.

1. Primary Care: Structure and Power Dynamics

At the heart of NHS primary care lies the GP practice — independent businesses operating under NHS contracts (typically GMS contracts), providing frontline care to millions.

Dr. Al-Ramadani provided a foundational overview:

  • GP Practices: Most are partnerships that hold NHS contracts, making them agile decision-makers despite constrained budgets.
  • Primary Care Networks (PCNs): Groups of GP practices (typically serving 30,000–50,000 patients) collaborating to deliver enhanced services under the PCN DES contract.
  • Integrated Care Boards (ICBs): Strategic regional bodies overseeing population health and driving large-scale system-wide initiatives.
  • Federations: Optional groups of practices working together — more variable, less formalized than PCNs.

He emphasized that each layer has differing levels of agility, funding access, and procurement complexity. For innovators, understanding who holds the purse strings and decision-making power is key.

2. Who Buys What? Understanding Procurement Pathways

The procurement dynamics vary drastically:

  • GP Practices: Can adopt tools quickly, but budgets are tight. Perfect for early pilots.
  • PCNs: Slightly more bureaucratic, but hold larger budgets. Often better for solutions that span a population health need.
  • ICBs: Hold regional budgets for large infrastructure (e.g., EHRs), but require extensive evidence, compliance certifications, and long timelines.
  • Federations: Hit or miss. Some are highly organized, others less so. Due diligence required.

The takeaway? Tailor your go-to-market strategy depending on your solution’s scale, complexity, and intended user. One-size-fits-all doesn’t work.

3. Pressures in Primary Care: Where Help is Desperately Needed

Healthtech must solve real problems. Dr. Al-Ramadani outlined the three biggest pain points facing GP surgeries:

  • Access and Capacity: The infamous 8am phone line rush reflects a mismatch between patient demand and appointment supply.
  • Administrative Overload: Hundreds of letters, prescriptions, and lab results daily — often dealt with manually.
  • Workforce Burnout: GP recruitment and retention is faltering. Solutions that reduce clinician burden are vital.

Innovators who align with these pressure points will find a warmer reception — especially if they clearly articulate the value of their solution in relieving these burdens.

4. Value, Not Just Price: The Economics of Adoption

Healthtech companies often struggle with pricing. Dr. Al-Ramadani’s advice was crisp:

“Understand your value. If you price high, show your value is higher.”

He broke this down with a powerful example:

  • A BP monitoring tool may help meet QOF targets (value to GP).
  • It may reduce strokes (value to ICB).
  • It may reduce admissions (value to hospitals).

Your value case must speak to each stakeholder in the ecosystem — GP, PCN, and ICB — in their own language. Economic evidence matters just as much as clinical outcomes.

5. Integrated Neighborhood Teams (INTs): The Future Frontier

Perhaps the most exciting part of the session was the discussion on Integrated Neighborhood Teams — NHS England’s vision for truly community-based care.

This is the future:

  • Shift care from hospital to community.
  • Break silos between GPs, nurses, social care, pharmacists.
  • Operate as a cohesive, localized ecosystem.

Right now, INTs are in their infancy. But the opportunity is massive:

“Whoever builds the connective tissue between these teams — shared comms, shared records, shared workflows — will likely do very, very well.”

Dr. Khor predicted the emergence of a lightweight, platform-level solution that stitches together disparate providers and data sources.

6. Pathway Redesign: The Hidden Opportunity

Tech that merely slots into broken workflows may fail. Instead, Dr. Al-Ramadani advocated for co-designing new care pathways with providers:

  • Understand legacy inefficiencies.
  • Reimagine the flow of care.
  • Offer support in implementation, not just product delivery.

For example, rather than just selling a messaging platform, design and deliver the communication pathway that replaces the phone-tag chaos between nurses and GPs.

7. Where to Build: Priority Areas for 2025

Dr. Al-Ramadani listed key domains where innovation is not just welcome — it’s desperately needed:

  • Pre-consultation triage: Smart, sensitive systems to signpost patients and reduce unnecessary GP appointments.
  • Ambient documentation: AI scribes are already gaining traction. They save time and reduce burnout.
  • Chronic disease self-management: Tools that empower patients between appointments.
  • System navigation: Tools that integrate and rationalize the sprawl of services available in the community.
  • Integrated records and messaging: Seamless communication across multi-professional teams.

Closing Wisdom: Evidence, Patience, and Partnership

Final reflections from both speakers revolved around a critical point: solutions that endure are built slowly, with evidence.

Companies like See the Signs didn’t scale overnight. They collected local evidence, proved value, and only then scaled nationally.

So the advice was clear:

  • Start small.
  • Partner deeply.
  • Build evidence.
  • Don’t just sell — integrate, educate, and evolve the pathway itself.

Final Words

This session was an essential masterclass for any healthtech innovator serious about primary care.

It wasn’t just an overview of acronyms and procurement pathways — it was a call to build more thoughtfully, more humbly, and more collaboratively. Primary care doesn't need more products. It needs the right ones — delivered in the right way.

🧠💡 If you’re building in this space, bookmark this post and share it with your team. And if you're still unsure how to translate these insights into action — we're here to help.

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