Medicine and Science from The BMJ

What access to GPs tells us about the NHS 10 year plan, and online gambling

Jan 31, 2026
Spencer Murch, psychologist and gambling harms researcher, outlines why online gambling’s immediacy and ads deepen harm and calls for clearer regulation. Luisa Pettigrew, practising GP and policy fellow, warns that digital shifts and access policies risk fragmenting care and worsening continuity. Hugh Alderwick, health system researcher, connects patient experiences of primary care access to the NHS 10 year plan and its practical tensions.
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INSIGHT

Patients Prioritise Trusted, Quick GP Access

  • Patients value prompt, easily bookable appointments with a GP they know and trust above other changes.
  • Government shifts to digital, community care, and prevention don't necessarily improve that core experience.
INSIGHT

Digital And Community Shifts Have Trade-offs

  • Digital access can increase convenience for some but creates new exclusion and dehumanisation for others.
  • Expanded community teams risk fragmenting care and reducing continuity that patients value.
ADVICE

Define And Protect Core GP Functions

  • Define what general practice is for and align policies to preserve its core functions like continuity and coordination.
  • Design services and incentives that protect comprehensive, continuous, first-contact care.
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