The state of health care and adult social care in England 2024/25

Demand and capacity in GP services

Demand for GP services is continuing to grow, which in turn increases pressure on services.

NHS England figures show that the number of patients registered with GP practices continues to increase, with over 700,000 more patients on average in 2024/25 compared with 2023/24. This has resulted in bigger GP list sizes, with the average number of patients per practice reaching 10,172 in 2024/25 – an increase of 2.6% on the previous year, and 5.7% over 2 years.

An increase in the number of appointments recorded in GP systems also reflects this growing pressure, with figures for 2024/25 up by 9.8% over 2 years. The number of appointments attended also increased by 8% over the same period.

At the same time, our analysis of NHS England’s General Practice Workforce data shows that between 2022/23 and 2024/25, the average number of full-time equivalent (FTE) fully qualified GPs per 100,000 patients in England dropped by 0.7%.

There is still variation across integrated care system (ICS) areas, with an uneven distribution of fully qualified GPs – as at March 2025, figures ranged from 34 to 54 FTE fully qualified GPs per 100,000 patients.

Nevertheless, it is encouraging that the number of full-time equivalent (FTE) GPs in training per 100,000 patients in England has risen between 2022/23 and 2024/25 by 10%, and the government has committed to “training thousands more GPs” in its 10 Year Health Plan.

NHS England data suggests that the way GP appointments are being delivered in response to demand is changing. There has been a fall in the proportion of appointments carried out by GPs (down 3 percentage points to 44% in 2024/25 compared with 2022/23) and an increase in the proportion delivered by other direct patient care staff (to 25%, up 4 percentage points over the same period).

While most appointments continue to be carried out face-to-face (65% in 2024/25), the proportion of video and online appointments has grown (5.5% in 2024/2025 compared with 0.6% in 2022/23). Such initiatives to improve access to appointments are positive, but it is important to ensure that systems to do this are accessible for all people. As outlined in our section on health and care for autistic people and people with a learning disability, these groups of people, as well as others, can face difficulties in using the technology to book appointments, therefore choice and flexibility is key. And, in a survey commissioned by the Royal National Institute for Deaf People, many people commented on the fact that they cannot use the phone because they are deaf or have hearing loss, which leads to difficulties, particularly for accessing GP appointments.

Access to GP services

While most patients report good experiences at their local GP practice, there are enduring access issues at the 'front door of the NHS'.

The 2025 GP Patient Survey received responses in the first 3 months of 2025 from just over 700,000 people about their experience of local NHS GP practice services. The survey found that, of those who had tried, just over half of respondents reported that it was easy to contact their GP practice by phone (53%) in 2025. While this is a 3 percentage point improvement on last year (50%), around 1 in 3 (35%) respondents said it was difficult, and 1 in 7 (14%) said it was ‘very difficult'.

In 2025, more respondents had used online methods the last time they contacted their GP practice, including the practice website and the NHS App, than in 2024 (up 3.1 percentage points and 2.2 percentage points respectively). Of those who said that they had tried these methods, there was a small increase in the proportion saying they found it easy:

• 51% said that it was easy to contact their GP practice using the practice website, compared with 48% in 2024
• a slightly lower proportion (49%) said that it was easy to contact their GP practice using the NHS App (45% in 2024).

However, significant numbers of people continue to report challenges, with just over 1 in 3 saying that contacting their GP using the NHS App (36%) and using the practice website (34%) is difficult.

These survey findings are echoed in the feedback we have received from people using services through our Give feedback on care service. People told us about early morning calls, long waits in call queues and for call backs, and frustrating policies and procedures that make them feel like there are not enough appointments available to meet demand.

Getting an appointment can be particularly difficult in the morning if the booking period clashes with commitments such as commuting or the school run:

Working people are unable to get an appointment unless calling at 8am. Can't call at that time as that is the time for getting ready for work and school.

We know that experiences of seeking care can also be shaped, positively or negatively, by interactions with non-clinical staff, as the following highlights:

Went to see the doctor but could not get an appointment. Been aggressively turned away from the [receptionist]. Had to almost insist we need to see the GP as it’s an emergency.

[The receptionists] are very helpful and welcoming, they can help you sort out any problems with my doctor and get any problems you have sorted out.

Where online booking systems have been implemented well, we hear that this can support access. But practices must ensure that, as in NHS England’s guidance, the “introduction of these systems is balanced against the nature of the local population to avoid introducing additional inequalities”.

Feedback from autistic people and people with concerns about their mental health show that GP practices do not always offer the reasonable adjustments needed to support them to make appointments online or by telephone. These barriers can also affect other groups, such as older or frail people:

Telephone appointments are completely inaccessible to me … It often takes 1-2 months of near-daily emails to make an appointment … or receive an answer to a question. This does not feel like equal access to healthcare.

As the government commits to going ‘digital by default’ in attempts to end the 8am scramble, practices will need to consider how to implement change in ways that minimise digital exclusion and consider the impact of health inequalities. (See more on this in our section on Health and care for autistic people and people with a learning disability.)

The 2025 GP Patient Survey also points to some marked inequalities in people’s experiences of accessing a GP. Among the groups least likely to describe their experiences of contacting their GP practice by phone as easy were autistic people, those reporting a mental health condition, a neurological condition or a learning disability, or another long-term condition or illness.

The 2025 survey also found that the ease of contacting a GP practice by phone varied by:

• socio-economic characteristics of the area where respondents lived – with those in the most deprived areas less likely to describe their experience as easy (50% compared with 54% from the least deprived areas)
• ethnicity – Black and Black British people were most likely to say it was easy to contact their GP by phone (63%), whereas Asian and Asian British people were least likely to find it easy to do this (48%).

It can be particularly difficult for prisoners to access GP appointments, as we have found through our joint inspections with His Majesty's Inspectorate of Prisons. For example, at one prison, there was a wait of up to 2 months for a nurse triage appointment, with a further 10 days’ waiting time to see the GP, which was too long. The report for this inspection cited “insufficient capacity in GP clinics”, and also noted that “Primary care and GP provision was under pressure because of the high number of arrivals.” We report on these issues in prisons and can take enforcement action to support better outcomes for prisoner healthcare.

People's experience of GP services

Most people who responded to the 2025 GP Patient Survey reported a positive experience, as 75% of respondents stated that their overall experience was ‘very good’ or ‘fairly good’, compared with 74% in 2024. But there is a substantial minority who did not have a good experience of GP services, with almost 12% reporting a ‘fairly’ or ‘very’ poor experience (13% in 2024).

Through our Give feedback on care service, we hear of positive experiences of GP services. Care and treatment by clinical staff is perceived as kind, and people tell us that they show a willingness to listen and offer excellent advice and help.

When people have negative things to report on their experiences of staff, these concerns are often around interactions between the doctor and patient and communication. People report not feeling listened to, or say that the GP is being dismissive of their concerns.

As recognised by the Royal College of General Practitioners, “Continuity of care is a critical element of general practice, particularly, continuity of the personal relationship between patients and their general practitioner.” ‘Bringing back the family doctor’ is also part of the government’s GP reforms.

Continuity of care

Unfortunately, continuity of care is not yet widely reflected in people’s experiences. In the 2025 GP Patient Survey, of the people who said they had a preferred healthcare professional, 43% said they only got to speak with them ‘sometimes’. Nearly a fifth of respondents (18%) said that they ‘never’ or ‘almost never’ got to speak with their preferred healthcare professional.

Access to a preferred healthcare professional is unevenly distributed. According to the GP Patient Survey, only 34% of respondents from Black/African/Caribbean/Black British, and 35% of Asian/Asian British respondents got to see their preferred healthcare professional ‘always’, ‘almost always’, or ‘a lot of the time’, compared with 42% of White respondents (figure 1). There is also a socio-economic difference, with 43% of those living in the least deprived areas being able to see their preferred professional ‘always’, ‘almost always’, or ‘a lot of the time’, compared with 36% of respondents in the most deprived areas.

Figure 1: How often do you get to see or speak to your preferred healthcare professional when you ask to? (by ethnic group)

Source: 2025 GP Patient Survey

These discrepancies are more concerning given the results of a survey carried out by the NHS Race and Health Observatory. This found “a worrying lack of trust amongst people of certain ethnic minority groups of the service or care that they receive”, with 51% of participants reporting some form of discrimination. This included alarming rates of racial or ethnic discrimination, with 38% of Asian participants and 49% of Black participants reporting that primary care providers treat them differently due to their ethnicity. The report also showed that, compared with White British patients, people in ethnic minority groups reported worse experiences in their communication with their GP practice and felt they were taken less seriously.

Communication

There are also issues in the co-ordination between GP practices and other healthcare services. People have shared their experiences of problems when accessing other health and care services through their local GP, for example issues with referrals, incomplete or inaccurate information, or delays in actioning recommendations. This disconnection may represent a particular risk for some people, as those who are most vulnerable may fall between the cracks or experience additional delays in getting the care they need.

Managing conditions and assessing needs

We have seen through our inspections that GP practices do not always manage long-term conditions in line with guidance. For example, we served a Warning Notice to a practice in 2024, as we were not assured that the service was operating an effective system to ensure that patients received necessary and timely monitoring, blood tests, and medication reviews across a range of medical conditions.

How does access to a GP affect other parts of the system?

Primary care is a vital element of the government’s 10-year plan to transform the NHS, which includes shifting care from hospital to the community. But rising demand and access challenges, together with pressure on the workforce, raises questions as to whether the sector is sufficiently equipped to support the delivery of care closer to home.

When people’s needs are not being met by their GP practice (such as those who face barriers to accessing GP services, as outlined above) it can lead to pressure on other parts of the health and care system, as people might seek care or treatment elsewhere.

Findings from the 2025 GP Patient Survey show that around 1 in 5 patients (22%) said they could not contact their GP practice or did not know what the next step would be at their last GP contact. While most of these patients went on to seek further care or treatment from primary care, just over 1 in 15 went to A&E (6.6%) and just under 1 in 20 (4%) went to an urgent treatment centre (figure 2).

Looking at this from a socio-economic perspective, the proportion of people who went to A&E because they could not contact their GP or did not know what the next step would be was 4 percentage points higher for people living in deprived areas (8%), compared with people in the least deprived areas (4%).

Figure 2: A breakdown of the 22% of patients who couldn’t contact their GP practice or did not know what the next step would be after contact, showing their actions

Source: 2025 GP Patient Survey.
This is a multiple choice question so percentages may not add up to 100.

Variation in patterns of access and demand reinforces the need for local systems to understand and engage with local communities to develop solutions that deliver proactive and person-centred community-based care. This could help local systems ensure that people receive appropriate advice and support on where to go and how to navigate access to primary and secondary services. It could also reduce the risk that some people might simply stop trying to get the care they need, which would therefore reduce health inequalities.

Dental care – access and experiences

Adults

In last year’s State of Care report, we highlighted how people were struggling to access NHS dentistry. These struggles appear to have persisted, and we continue to see variation in people’s access to services and their experience of dental care.

The 2025 GP Patient Survey also asks questions about dental care. It found that just under half (49%) of respondents had not tried to get an NHS dental appointment in the last 2 years or had never tried to get an NHS dental appointment. When asked why, of those that had tried to get an appointment, just over a quarter (26%) said that they did not think they could get an NHS dental appointment, suggesting a lack of confidence in accessing these services."

Similarly, a Healthwatch England poll from September 2024 found that, of those unable to get an NHS dental appointment in the last 2 years, just under a quarter (24%) said this was because they were not on an NHS dentist list and could not find an NHS dentist that was accepting new patients.

When we consider data on NHS dental provision we see that, as at November 2024, only 2 in 5 (39%) adults had seen an NHS dentist in the last 24 months and, in some integrated care system (ICS) areas, figures were as low as 1 in 3 (27%).

The dental activity delivery rate is a key measure of performance and delivery of NHS dental services. This shows more notable geographic variation – varying by more than double when we look at extremes of performance. This indicator enables us to see how much of the commissioned NHS dental work that dentists in a geographic area have delivered.

Dental practices in the top-performing ICS delivered 97% of their contracted units of dental activity in 2023/24, compared with 48% in the lowest-performing ICS.

At a national level, NHS Dental Statistics published August 2025 show that there was a 4% increase in courses of dental treatment delivered in 2024/25 (compared with 2023/24). Additionally, the total units of dental activity completed in 2024/25 showed a marginal increase (up 1% compared with the previous year). However, this still remains 8% lower than the total units completed in 2019/20, which shows that the dental sector has not recovered to pre-COVID pandemic rates of completed dental activity.

Our analysis of data on dental provision and activity also indicated a link between performance and whether an area can be classified as urban or rural. We saw that ICS areas with the highest proportion of contracted units of dental activity completed and those with the highest proportion of adults who have seen an NHS dentist tended to have a more urban composition than those with the lowest, which tended to be more rural.

Efforts to improve equity in dental access for those in rural areas were reflected in the NHS dentistry recovery plan, which was introduced in 2024 and ended in March 2025. As well as initiatives to address workforce issues, the plan introduced incentives to dentists to practise in areas where NHS dental provision was particularly low (often referred to as ‘dental deserts’).

Inequalities in access to dental care are reflected in people’s experiences, as shared with us through our Give feedback on care service. When looking specifically at feedback from people who are entitled to free NHS dental care, we see people reporting difficulties in registering for NHS care in their local area and being unable to access timely appointments for routine NHS care. For example:

I am currently pregnant and now left without a dentist. There are no dentists in my region or even the next which are taking on new NHS patients.

Access to NHS emergency care also emerged as a concern. People told us about issues they experienced when contacting NHS 111 for dental problems. This included being directed to dental practices with no available NHS appointments.

I am living daily in pain, as NHS 111 service gives you numbers to dentists who don't have appointments or don't have NHS dentists either.

We also saw descriptions of appointment ‘gatekeeping’ when accessing emergency care. For example, being told they could access urgent care sooner on a private basis than through the NHS.

ICS areas are tackling healthcare inequalities in response to issues with access to dental care. For example, Suffolk and North East Essex Integrated Care Board has shared how it has approached making routine and urgent NHS dental care available to all through its dental commissioning strategy. This included establishing recruitment and retention packages to improve workforce availability, establishing a mobile dental clinic to target areas of greatest need, prioritising access for groups of people who are more vulnerable (including those in the Core20PLUS5 groups), and commissioning additional services to allow more NHS appointments to be made in the evenings, at weekends and on bank holidays.

Once they can access dental care, many people are positive about their experience of dental services.

The 2025 GP Patient Survey found that almost 3 in 4 people had a good experience of NHS dental services (71%). Similarly, Healthwatch data for September 2024 suggests that over 4 in 5 people seen by an NHS dentist felt that their dentist put them at ease (82%) and treated them with respect (85%).

This satisfaction is also reflected in much of what we hear about dental services from people sharing positive experiences of care and treatment through Give feedback on care. Our analysis of a sample of feedback highlighted some key characteristics of good patient-reported experience, such as:

• ease of booking appointments, particularly timely access to emergency care and flexibility around appointment times
• positive interactions with kind, professional and reassuring staff, with a focus on the patient feeling informed and at ease
• clear and concise communication around treatment options, including information about costs, the risks and benefits of treatment and the nature of the procedure
• adequate time to ask questions and interact with clinical staff
• good pain management when undergoing treatment, including good communication and an empathetic approach from staff.

Feeling informed and at ease was highlighted as particularly important for those with complex needs, older or frail people, and children and young people. There was evidence to suggest that positive interactions with welcoming and empathetic staff can support people to overcome anxieties around dental treatment.

I am so lucky to have found a fantastic practice that is so caring. My dentist and staff make me feel so comfortable and are very welcoming. They discuss everything with me. I was so nervous when I first came, but the reassurance has truly helped me. They are always there to help.

But we know that this isn’t the case for everyone, and we see evidence of inequalities beyond issues of access to dentistry. The 2025 GP Patient Survey found that people living in the most deprived areas were less likely to describe their experience as good (67% compared with 75% in the least deprived areas). We also see variation in experience by ethnicity. For example, of the people who described their experience of access to an NHS dental service as good:

• 72% of people were from a White ethnic background
• 69% of people were from a Black African/Caribbean or a Black British background
• 65% of people were from an Asian/Asian British background.

Children and young people

Mirroring the adult population, the issues facing children and young people in accessing NHS dentistry have persisted. Dentistry data in England show that the overall proportion of children accessing NHS dentists has improved marginally, from 55% in 2023/24 to 57% in 2024/25.

However, again, performance varies across ICS areas. As at November 2024, in the poorest performing ICS area, as few as 40% of children (aged under 18) saw an NHS dentist in the last 12 months. Whereas in the highest performing ICS area, this figure was 65%. These findings point to persistent challenges with access to NHS dentistry for children and young people, as well as inequalities in access to NHS dentists across the country.

Through our Give feedback on care service, we hear from parents and carers that getting an NHS appointment for their child or young person can be challenging, and this can be compounded by the practice of de-registration, where a patient is removed from the practice list following gaps in attendance and/or missed or cancelled appointments due to factors including illness. When they have been de-registered, patients reported struggling to access alternative NHS dental services. A lack of communication between practices and patients about de-registration was also prevalent in feedback shared:

They de-registered my children before COVID! I've requested numerous times for my children to be registered and got nothing but excuses! My children have waited years to see a dentist. It's appalling.

This concern speaks to an overall confusion about people’s rights to registration. For example, according to research from Healthwatch England, over two-thirds (68%) of respondents mistakenly believe they have the right to register with an NHS dentist in the same way they do with an NHS GP.

In the context of concerns around access to routine and preventative dental services for children, data shows geographical variation in the rate of children and young people who are admitted to hospital for tooth extractions due to tooth decay per 100,000 young people under 19 years, as measured by finished consultant episodes. At the extremes, one ICS had a rate of 994 per 100,000 young people under 19 years, compared with another ICS at 17 per 100,000 young people under 19 years in 2023/24 (figure 3).

Figure 3: The rate of decay-related tooth extraction episodes per 100,000 young people aged 0 to 19, by integrated care system in 2023/24

Source: UK Gov HES

Analysis undertaken by the Office for Health Improvement & Disparities also highlights that in 2023/24, the decay-related tooth extraction rate for children and young people living in the most deprived communities was nearly 3.5 times more than for those living in the least deprived communities.

It is good to see this recognised in NHS England’s 10 Year Health Plan for England, which states, “Children will be our urgent priority. Tooth extraction is the leading cause of hospital admission among children aged 5 to 9 years old, yet it is almost entirely preventable.” Addressing the backlog of tooth extractions in hospital for children is also one of the 5 areas of focus in NHS England’s Core20PLUS5, which aims to support the reduction of health inequalities at both national and system level.

District nursing

District nursing services deliver a wide range of nursing care to people in their own homes, support people to live more independently, and prevent and treat acute illnesses. Disabled adults, people who are near the end of their life, and older people living with frailty and long-term conditions often need these services. These services can take pressure off secondary care services by preventing admissions to an acute hospital and facilitating earlier hospital discharges. District nursing services are delivered by multi-disciplinary teams, with their core role being the qualified district nurse.

Effective district nursing services are an important part of delivering the government’s 10-year plan to transform the NHS – specifically, its aim to shift care from hospital settings into the community.

Data from NHS England shows that the monthly average of full-time equivalent (FTE) level 1 qualified district nurses has fallen from 6,745 in 2010/11 to 3,871 in 2024/25, which is a 43% drop overall (figure 4). Some of this early decline may be influenced by the transfer of some staff to Community Interest Companies (CICs) following the Health and Social Care Act 2012, but there continues to be significant decline since 2012/13.

In the context of an ageing population that relies on this service, this reduction presents a 50% drop in qualified district nurses per 10,000 people aged 65 and over (from 7 in 2011/12 to 3.5 in 2024/25).

Figure 4: Monthly average FTE level 1 qualified district nurses in England, April 2010 to March 2025

Note: this analysis is based on the NHS England officially published workforce statistics and excludes non-level 1 practitioners and staff from non-NHS providers (particularly CICs). The decline from 2011/12 to 2012/13 is influenced by the transfer of some staff to CICs following the Health and Social Care Act 2012.

In addition, the demand for district nursing services is rising. Based on our analysis of a bespoke extract of NHS England Community Services Dataset, the volume of new referrals to district nursing services for people aged 65 and over has risen by 28% between 2021/22 and 2024/25 (from nearly 2.7 million to just over 3.4 million). If we also include the growth in closely associated Crisis Response Intermediate Care services (which include other professions but rely on district nursing staff for short-term reactive care), the volume of new referrals has increased by 50%. The monthly average of FTE qualified district nurses has reduced slightly in this period, falling by 3%.

This increase in demand is reflected in the results of a 2023 national survey of District Nurse Team Leaders from the Queen’s Institute of Community Nursing, with over 1,500 UK staff responding. The number of team leaders who reported a team caseload of over 600 cases increased from 12% in 2019 to 16% in 2023, while those reporting a team caseload of under 200 cases decreased from 32% to 28%.

Findings from the 2024 NHS Staff Survey reflect the impact of the increased demand for district nursing services on workloads, with only 40% of district and community nursing staff reporting that they could meet all the conflicting demands on their time at work, compared with 47% of all respondents. Also, 71% of district and community nurses reported doing unpaid overtime compared with 58% for registered nursing overall and 50% for all respondents.

The survey from the Queen’s Institute of Community Nursing also showed that the district nursing workforce was struggling to meet all the demands placed on it, with 32% of respondents saying they delay or defer visits every day, and 90% saying they do this at least once a week.

Clearly, this is having an impact on the people who use these services. When the survey asked district nurse team leaders which aspects of patient care were not undertaken to a satisfactory professional standard:

• 43% said psychological care and support
• 39% said assessments
• 31% said continence care.

Team leaders commented that the lack of time and resources were driving their services to focus on task-orientated care rather than holistic care for their patients – especially regarding their emotional and social needs. This sentiment is also fed back from nurses contributing to a 2025 report by the Commission on Palliative and End-of-Life Care, another service largely delivered by district nursing.

Exploratory analysis has shown that there is a relationship between the year-on-year decline in provision of qualified district nursing and acute hospital re-admission rates for people aged 65 and over (from 2013/14 to 2023/24).

During our inspections of community healthcare services, we have noted the risks of services taking on too many referrals. For example, we found that one provider of district nursing services had created lists for people who were prioritised for visits into either a ‘red’ (or ‘critical’) list or a ‘deferred’ list of people who were lower priority. Some people spent many days on the ‘deferred’ list but ended up on the ‘red’ list as their health had deteriorated. We also observed additional problems in relation to a shortage of qualified district nurses.

The shortage of qualified district nurses is partly a result of many years of insufficient recruitment of trainees. Our analysis of NHS electronic staff record data shows that total annual numbers of new trainees are rarely more than half the number of staff leaving the profession. The government announced an ambition to expand centrally-funded places for district nursing trainees by 150% by 2031/32 in the NHS Long Term Workforce Plan, but it remains to be seen whether this will have a sufficient impact on the supply of this vital staff group.

Use of artificial intelligence (AI) in general practice

In the NHS 10 Year Health Plan, harnessing the advances in artificial intelligence is seen as one of the core elements of shifting care from analogue to digital. We carried out some work to find out the views of key stakeholders on the use of artificial intelligence (AI) in general practice. By speaking with GPs, patients, commissioners, healthcare providers and professionals, and AI organisations and developers, we gathered insights from over 30 organisations to inform our regulatory approach to AI in general practice.

We published guidance for providers on the use of artificial intelligence (AI) in GP services, and the Equality and Human Rights Commission has also published guidance to help public sector bodies embed equality considerations regarding the use of AI.

Views of the public

In March 2025, we surveyed 2,000 members of the public who had visited their GP in the last year. A large majority (nearly 9 in 10) of respondents are at least somewhat familiar with the term ‘AI’.

However, more respondents expressed negative feelings (47%) towards AI than positive (35%), and 19% were unsure – signalling mixed sentiment.

People had very different thoughts on a GP specifically using AI to support clinical decision-making, with 41% feeling positive and 42% feeling negative about AI supporting clinical decisions.

Respondents were most concerned about:

• AI making errors (83%)
• staff being over-reliant on AI (82%)
• loss of human connection (81%)
• data protection and security (69%).

However, people felt there is potential for AI to improve access to a GP, as 41% believe AI would make it easier to get an appointment, and 40% felt it would reduce waiting times for treatment.

Only 27% of respondents thought the use of AI by GPs will make their care better, with 41% unsure.

Views of GPs

We also surveyed GPs in April 2025 to find out their views and experiences of using AI. We received 156 responses from GPs across England so, although not representative, this sample provides some indicative insights.

When asked whether their practice was currently using AI:

• 42% said ‘yes’
• 31% said ‘no’
• 27% said ‘no, but we’re currently looking into adopting AI’.

Respondents said the most common use of AI was for administrative purposes, such as note-taking, triage and appointment scheduling, and the key motivation to adopt AI is to help improve efficiency and reduce administrative burden (93%), followed by improving the quality of care for patients (76%). One respondent summed this up by saying:

AI does not replace the relationship between a patient and their GP. When AI is used right, it should make space for more human connection, not less, by taking away the busy work so clinicians can focus more on people.

Over four-fifths (81%) of GPs thought that AI will have a positive impact on GPs in the next 5 years. However, nearly half (46%) were unsure if AI would improve health inequalities.

The main barriers that limited adoption of AI in general practices were:

• lack of funding (73%)
• unclear regulatory requirements (69%)
• concerns over professional responsibility or liability (66%).

When asked how practices monitor AI, by far the most common answer was ‘There is no formal monitoring in place’. The majority of respondents (81%) said that a national AI safety checklist or framework would help improve oversight of safety, as the following point highlights:

It feels inevitable. As GPs, we are being asked to achieve more and more with less and less resource, and so AI is likely to be able to perform some tasks for us. I am, however, deeply worried about how it will be governed. I can foresee a future where I have no option but to adopt AI based GP software, but am then held liable for its errors.