Opinion: Why GPs must signpost to help primary care

By Sharon Hanley, director of Primary Care, X-on Health

General practice is operating under unsustainable pressure, it has long been the front door to the NHS, but despite the introduction of tools such as digital and AI automations designed to assist GPs, the weight of demand is intense.

Rising patient need, widening inequalities, and a constrained workforce means the model of primary care as gatekeeper to the NHS is no longer sustainable, nor suitable.

If the ambitions of the NHS 10 Year Plan are to be realised, the role of general practice and the modern digital front door must evolve.

The future is not about primary care controlling access to the system, but guiding patients through it and signposting to trusted community services such pharmacy, voluntary and third sector services wherever appropriate.

In addition to the modernisation of services through digital support, this is the key to reducing pressure on practices and to ensure that patients can access the right care, first time, using the tools they are most comfortable with.

The shift to neighbourhood services

The 10 Year Plan sets out a core redesign of care from sickness to prevention and hospital to community.

Its vision is for neighbourhood health services is built on three principles: to be locally integrated, community-based, and digitally supported.

These services bring together general practice, community providers, mental health teams, and voluntary organisations to deliver care that is preventative and closer to home.

Neighbourhood Health Centres are envisaged as local one-stop shops, providing extended hours, diagnostics, mental health support, enhanced pharmacy services and more.

But this vision depends on patients being able to navigate seamlessly into and across these services. Without effective routes in, the system risks defaulting back to the GP as the first and only port of call.

AI-enabled care navigation tools like Surgery Assist directly support this ambition.

Designed to sit at the digital front door, it helps patients understand and access the most appropriate route to care, without relying solely on phone-based triage.

Why signposting is essential

Signposting is not an administrative add-on, it is a fundamental enabler of neighbourhood health services.

By directing patients to the most appropriate source of assistance, signposting prevents unnecessary GP appointments, reduces waiting times, and strengthens the role of other parts of the system.

Take the example of alcohol-related concerns.

In 2023/24, there were an estimated 1,018,986 hospital admissions related to alcohol consumption in England alone, yet many of these would not have required clinical intervention from the outset.

Looking to the future, though innovative approaches such as our AI Surgery Assist chatbot partnership with Drinkaware, patients can be guided to trusted resources which provide evidence-based information and tools to support behaviour change.

In this way, signposting ensures that patients receive timely support while preserving GP time for cases that genuinely need medical input.

Signposting also aligns directly with the preventative ambitions of the 10 Year Plan. By connecting people earlier to support for issues such as lifestyle, mental wellbeing, or social challenges, the system can intervene and reduce the likelihood of more serious problems emerging later.

The role of digital access and automation

For signposting to work at scale, practices need digital infrastructure that makes it simple and consistent.

The digital front door must do more than offer online appointment requests: it must help patients understand the range of services available and provide a safe route to access them.

Automation can help by guiding patients to the right care at the first point of contact, whether that is pharmacy, a local clinic, or a third-sector provider.

In practice, this means fewer unnecessary phone calls, reduced duplication, and a clearer, more efficient flow of demand across the system.

Alongside navigation, communication platforms such as digital telephony and online chatbots provide practices with tools to manage peaks in demand and coordinate across multiple sites.

Data and insight drawn from these digital interactions can also support neighbourhood teams to plan resources more effectively, shifting from reactive responses to proactive, population-level management.

Protecting the importance of GPs

This evolution is not about reducing the importance of GPs, quite the opposite.

By removing non clinical demand from the system, signposting allows GPs to focus on the complex, relationship-based care that they can deliver.

In this sense, signposting is not a threat to general practice, it is its safeguard.

Without it, demand will continue to escalate, leading to longer waits, greater inequity, and further strain on the workforce. With it, GPs can reclaim the space to deliver personalised, continuous care for those who need it most.

A system-wide responsibility

Signposting cannot be left to individual clinicians making ad hoc decisions. It must be embedded into the design of access itself.

That means ensuring patients encounter clear, safe navigation at the first point of contact, whether that is through the practice telephony, AI chatbot or the NHS App.

It also means building confidence in the services patients are directed to, so that signposting is trusted, not perceived as a barrier.

Technology has a key role to play in enabling this, but the principle is broader: a whole-system approach where general practice works in partnership with community providers, pharmacy, and the voluntary sector.

Signposting is the practical mechanism that makes neighbourhood health services function as intended.

Primary care cannot continue as the gatekeeper

General practice cannot continue as the default gatekeeper to the NHS.

The pressure is unsustainable, and the consequences for patients and clinicians are already clear.

The future must see primary care as signposting and directing patients to the most appropriate sources of help within a connected, neighbourhood-based system of care.

By embedding signposting into the fabric of primary care, we can protect the future of general practice, make better use of community and voluntary resources, and ensuring patients receive care that is timely, effective, and centred on their needs.

The 10 Year Plan has already articulated the vision.

The task now is to act, embedding signposting to community and the third sector as a core feature of the digital front door and making the neighbourhood-first model of care a reality.

At X-on Health, we are already supporting over 3,500 practices do just that.

As neighbourhood health services become the default, we’ll continue to help frontline teams provide care that’s closer to home for all.