BNSSG Healthier Together

Joint Forward Plan

Communities and primary care

GP listening to a child's heart beat with a stethoscope. The child is sat on their parents knee.

Why it’s important

Primary care is the front door to the NHS and is an essential element of a high-quality and cost-effective health system. However, we know that primary care is experiencing many challenges such as demand and capacity, workforce and estates. There is a growing level of same-day demand, with more cases of severe or complex conditions, which has impacted continuity of care.

We are working to increase capacity in primary care so that people can get the care they need locally at the right time, rather than later or at A&E departments.

Primary care services focus on keeping people healthy, identifying the onset of more serious conditions and supporting people closer to home. By addressing health issues early on and supporting people to leave hospital as soon as they are medically well enough, it can reduce the burden on our local hospitals.

In addition to general practice, our pharmacy, optometry and dental services are critical to improving health outcomes and the promotion of good health for the residents of Bristol, North Somerset and South Gloucestershire, including:

  • Further promotion of community pharmacy in being a key access and delivery partner across a wide range of preventative care.
  • Embedding eye care and health in both local and system services.
  • The promotion of good oral health, particularly for children.
  • Better access to NHS dentistry.


What we can do

  • In general practice we’re continuing to tackle demand peaks and reduce the number of people having trouble in contacting their practice, restoring patient satisfaction in accessing services.While people can still access their GP Practice through the usual routes, we want to continue to support the move to a digitally enabled operating model. We’re making significant progress here, with digital telephone systems, electronic patient records, supporting technology enabled care and more. We want to take this is the next level and increase functionality, for example putting call-back systems in place to prevent local people from waiting on the phone while trying to contact their GP practice.Alongside this, we’re developing and implementing a primary care workforce strategy for both clinical and non-clinical staff. This will help to improve recruitment, training, development, wellbeing and retention across the system.
  • Within community pharmacy, we’ve launched Pharmacy First so patients with minor illness or common conditions can be seen by their local community pharmacist without seeing a GP. Alongside this, we’re piloting community pharmacists independently prescribing for minor ailments.
  • In optometry services we’re enabling direct referrals from primary care optometry sites using a uniform IT system, implementing a new macular pathway and exploring the implementation of a community urgent eye care service.
  • In dental services, we’re continuing to improve the units of dental activity (UDAs are a measure of the amount of work done during dental treatment) while identifying and developing service models for vulnerable groups such as care home residents and migrants. We want to maintain and improve urgent care access and unmet need, exploring ways we can align work with community and urgent care dental services. On top of this, we want to increase work on oral health improvement, especially for children.


Pharmacist Ade Williams discussing the Pharmacy First scheme in Bristol, North Somerset and South Gloucestershire.



How we’ll measure progress

  • Make it easier for people to contact a GP practice, including supporting general practice to ensure that everyone who needs an appointment with their GP practice gets one within two weeks and those who contact their practice urgently are assessed the same or next day according to clinical need.
  • Provide a number of ways to access general practice including face to face, telephone and online.
  • Continue to increase the number of Pharmacy First referrals to over 7000 per month.
  • Recover dental activity, improving units of dental activity (UDAs).
  • Increase our capacity within primary care by retaining and increasing the number of staff in the area.

This page provides an overview. To read about our plans in detail, take a look at the full Joint Forward Plan 2024-2029.

Joint Forward Plan 2024-2029

Strategic Commitments

Align everything we do to the outcomes we want
Demonstrate our system-wide commitment to prevention
Focus on the first 1,001 days to give our children the best start
Change how we work to reduce health inequalities actively
Prioritise the health impacts of poverty and disadvantage
Build a workforce who are supported, skilled and healthy
Focus on the whole person – not just the disease
Work together as equal partners to tackle our biggest problems
Support the economy with our purchasing and employment practices
Develop a better, healthier environment for people to live in

Outcomes Framework

The healthy life expectancy of our population
The health and wellbeing of our population
The health of services
The health and wellbeing of our staff
The health and wellbeing of our communities
The health and wellbeing of our environment