We all want to see a shift to a more preventative and population-based health and care system. Primary care is essential to this vision, and recent government policy emphasises the need for action in three key areas: Access, Continuity and Prevention. But with services and staff under pressure, how should leaders proceed?

At the heart of transformation

Systems are putting primary care at the heart of their transformation – finding new ways to integrate services and work together across General Practice, Community Pharmacy, Optometry and Dentistry, as well as with secondary care and other partners.

New ways of addressing demand for non-complex same-day care – e.g. through better use of community pharmacy – can improve citizen and staff experience – and begin to reduce pressure in systems.

​Working as part of Integrated Neighbourhood Teams, primary care staff can deliver more holistic, continuous care to those with greater complexity.

Through collaboration with Local Authorities and community groups, using population health management, efforts can be aligned to prevent ill health and narrow health inequalities.

Our approach

Our approach to helping systems to redesign their model of care for Primary Care has three distinct steps:


  • Build a shared understanding of the current state of primary care services
  • Conduct detailed data analysis to understand current and future demand for primary care services
  • Research and select good practice case studies
  • Build a case for change that meets the needs of the system’s population.


  • Obtain consensus on the future vision for the model of care
  • Design the operating model that can deliver the agreed vision
  • Define, test and refine the model of care and enablers
  • Agree a set of priorities for the Model of Care to drive improvement
  • Develop a business case that demonstrate costs and benefits


  • Support ICBs and Primary Care to drive continuous improvement in their agreed priorities
  • Set up ‘pilot’ sites to test the application of the Model of Care and support through 30-day action periods
  • Define and agree implementation through further waves


KPMG’s approach to Primary Care transformation is based on a rapid cycle approach to transformation that engages frontline staff to develop strategy and deliver bottom-up change.

We have experience of working with Integrated Care Systems, Primary Care Networks and Primary Care clinicians nationally and globally. This has enabled us to distil national and global examples of high-performing primary care systems across each of the three core components of Access, Continuity & Prevention.

The reason why we are uniquely placed to help you is because we are/have:

  1. Implementing the Fuller vision on the ground: We are engaged in two live projects with Integrated Care Systems to design, test and implement how the Fuller vision will be delivered in their area so we can bring live actionable insights to the design groups.

  2. A clinically-led team: Our team is led by a former NHS General Practitioners, Dr Amit Sethi, bringing credibility and helping build trust with stakeholders.

  3. Unique insights into the Fuller Stocktake model: We understand the detail behind the vision and model of care in the Fuller Stocktake, and have insights into the recommendations and how to implement these as Gina Naguib-Roberts led this work day-to-day while at NHS England.

  4. Experts in global good practice: Dr Amit Sethi has extensive experience of healthcare transformation internationally, and access to KPMG’s global healthcare practice that spans 70 countries to leverage good practice insights.

  5. An ecosystem of Partners: We can bring our Alliance Partners to the table, including Microsoft, making it easier for you to gain a breadth of insights coordinated through KPMG as your single Programme Partner.

  6. Experts in learning, leadership development and facilitation: KPMG is the second largest learning provider in Europe, and a key provider of the NHS Leadership Academy.

Our support to North West London ICB

NWL wanted to change the pathway for ‘same day non-complex’ demand so it was dealt with more effectively and efficiently, freeing up time for more complex patients and prevention initiatives.

We worked with 10 PCNs to co-design and support implementation of a new Same Day Access Hub model. This informed the ICB’s commissioning plans and we are supporting this wider implementation across the remaining 35 PCNs. Early feedback suggests:

High utilisation rates (90-100% per day for one hub)

Greater resolution of patient needs without follow-up appointments (90.5% of patients accessing one hub needed no further action from their ‘usual’ practice)

High patient satisfaction rates (74% patient satisfaction in one hub) with patients noticing they are getting appointments faster

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