Winter pressures in general practice in England

Every winter, the NHS braces for surges in demand, with effects across the system.However, focus has often centred on hospitals, but the reality is that much of this seasonal strain often first lands in general practice, when practices are already facing growing demand for consultations, greater clinical complexity, and significant administrative burdens. 1 Despite its central role, winter pressures in general practice remain poorly characterised, as do the consequences of pressure on individual practices, on patient health, and on the wider system. 2 GPs already regularly report working at or beyond capacity, hence there is little flexibility to manage seasonal spikes. 1 Preliminary results from our NIHR-funded study, which has surveyed general practices in England (n = 191), shows rising pressure leading up to winter: 30% of general practices (n = 28/94) reported being very busy to burnt out in mid-October, increasing to almost 50% (n = 94/191) by early December (Dawadi, et al, unpublished data, 2025).3 Trends vary by practice, likely reflecting differences in patient case-mix, local respiratory epidemics, and how practices and demand are resourced and organised.Without national-level understanding and quantification of practice level pressures and their effect on the wider health ecosystem we cannot plan effectively, allocate resources fairly, or protect patient care during the most challenging months of the year.