Winter funding: where is the support for general practice?
In London, one ICB has allocated its 2026/27 winter funding to acute and mental health trusts, with no direct allocation for practices (Healthcare Leader, 7 October 2026). Londonwide Local Medical Committees (LMCs) say general practice was not engaged before the proposals were drawn up. The ICB says final decisions on how the money will be used have not yet been made. Nationally, the government's latest £140m winter package also includes no new funding for general practice (Pulse, 19 October 2026).
Hospital capacity matters. But winter pressure does not begin at the front door of A&E. It builds in the weeks before, in the practices that manage people's long-term conditions, and it returns to them after discharge. A winter plan that funds one end of that pathway and not the other is incomplete.
Access is more than appointments
Winter planning tends to judge general practice by one number: appointments delivered. That misses most of the work. As a GP, I know that every consultation sits inside a chain of tasks: triaging requests, arranging investigations, reviewing results, managing prescriptions and coordinating follow-up.
Routine care does not pause for winter either. Patients still need diabetes reviews, blood pressure checks and medication monitoring. All of it draws on the same clinicians and the same admin team who are absorbing the seasonal surge.
Proactive care is the first thing to slip
When on-the-day demand fills the diary, planned care gives way first. A review is pushed back. A recall goes unanswered. A monitoring blood test stays outstanding.
For someone living with COPD, heart failure or several long-term conditions, that review was the chance to spot deterioration, adjust treatment and act early. These are often the same patients who need hospital care when winter peaks.
Sending an invitation is the easy part. The harder work is knowing who has not attended, following them up and making sure actions from the review are completed. That work rarely shows up on an access dashboard, and it is exactly what gets squeezed.
What winter support should include
If systems want general practice to keep patients well this winter, support has to reach the teams doing that work. I would ask commissioners to do four things.
- Bring general practice into winter planning from the start. Practices and LMCs should help shape plans, not learn about allocations after they are made.
- Fund the work around the appointment. Care coordination, reliable recall and clear ownership of follow-up are what turn capacity into completed care.
- Protect long-term condition reviews as a winter priority. Prioritise by clinical need, so the patients at highest risk are reviewed first.
- Measure completed care, not just activity. Alongside appointment numbers, track whether high-risk patients were reviewed and whether the actions from those reviews were done.
Where technology fits, and where it does not
I work at Abtrace, where we support practices, PCNs and ICBs with patient identification, monitoring and recall. The right tools help teams see which patients have outstanding care needs and organise follow-up, with clinicians making the decisions.
But technology is not a substitute for staff or funding. It can make a supported team more reliable. It cannot make an unsupported one sustainable.
Winter planning should start in general practice
Many of the patients who need hospital care this winter will be known to their practice long before they arrive. Leave general practice out of winter funding and the system gives up its best chance to act early.
General practice should be in the room when winter plans are written, and resourced for the work of keeping patients well.
If you are a practice or PCN working out how to protect long-term condition reviews this winter, we would be glad to compare notes.