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The GP contract and the ‘Community pharmacy contractual framework’ (CPCF) should encourage greater collaboration between the primary care providers, rather than offering competing financial incentives, according to a report by think tank The King’s Fund.
‘What should national policymakers do to make care closer to home a reality?’, which was published on 27 March 2025, detailed 15 issues and the actions needed by policymakers to tackle them in order to shift care out of hospitals and into the community.
Moving healthcare “closer to where people live” is one of three main focuses of the government in its plans to reform the NHS, alongside rolling out new technologies and focusing on prevention.
However, the report highlighted that “national contracts for general practice and community pharmacy have competing incentives”, which causes “challenges to joint working between these two sectors”.
The report called on the Department of Health and Social Care (DHSC) to ensure contracts were “coherent and complementary” and encourage collaboration.
“With the development of new national services, [the] DHSC should aim to increase overall capacity, not merely shift location,” the report said.
In December 2024, Community Pharmacy England (CPE) called on the government to “put community pharmacy at the centre of delivering its primary care priorities” by commissioning further services “in a way that encourages collaboration across primary care and beyond”.
The DHSC remains in talks with CPE on the CPCF for 2024/2025 and 2025/2026.
The report also highlighted that acute hospital providers have higher representation on integrated care boards (ICBs) compared with primary and community care services.
To resolve this, it called for more space to be made on ICBs for primary care sector representatives, namely by members representing sectors rather than organisations.
It also called for primary care contracts, particularly for pharmacy, to “reflect the funding required for these professionals to have the time to contribute to local partnerships and integrated working, including membership of ICBs and other boards”.
“If the focus of the system is to be primary and community services, then those on the board should reflect that focus and governance through rebalancing rather than expanding,” the report said.
Beccy Baird, senior fellow in health policy at The King’s Fund and co-author of the report, said: “The structure and focus of the NHS has failed to keep pace with changes in disease and ill-health. English hospitals are well-placed to support the most acutely unwell, but too often they are treating patients that could have had their condition better managed in the community.”
“Rebalancing NHS funding away from hospitals may sound counter-intuitive, and may even face some public criticism, but the truth is that the long-term solution to our over-crowded hospitals lies in boosting out of hospital services,” she added.
Tase Oputu, chair of the Royal Pharmaceutical Society England Pharmacy Board, said: “Pharmacies are at the heart of communities, providing vital access to care, particularly in deprived areas. As the first point of contact for many patients, they play a crucial role in delivering care closer to home.
“To maximise their impact, there must be adequate funding and incentives for collaboration across primary care — for example in vaccination services. Investment in the workforce, including protected learning time, is essential for professional development and improving patient care.”
A spokesperson for the DHSC said: “Along with an extra £26bn investment to get the health service back on its feet, we are bringing in fundamental reform that will mean more people treated in the communities they live in, as well as a vital shift from analogue to digital and sickness to prevention.
“We have also reduced the number of targets for NHS leaders and are abolishing NHS England — the world’s largest quango — to cut red tape and divert hundreds of millions to the front line.”
