Primary Care in Brighton & Hove: Demand, Access and the Local Market

Primary care in Brighton & Hove operates in a market that is both busy and unusually diverse.

The city has a large registered GP population, substantial appointment volumes, six Primary Care Networks, a well-distributed community pharmacy network and increasingly integrated neighbourhood services.

It also faces clear pressures.

Demand continues to rise. Access varies between practices and communities. Brighton & Hove has significant health inequalities, comparatively high levels of mental ill health and a growing population living with multiple long-term conditions.

At the same time, the way primary care is delivered is changing.

More activity is moving beyond the traditional GP consultation. Pharmacists, physiotherapists, mental health practitioners, care coordinators and other professionals increasingly work alongside doctors and nurses. Digital triage and online access are changing how patients enter the system. Integrated Community Teams are bringing primary care, community health, social care and voluntary organisations closer together.

For organisations considering entering or expanding within the primary care market, this means that demand is substantial, but opportunity increasingly depends on understanding where the system is trying to create additional capacity and how services fit into wider neighbourhood care.

Brighton & Hove primary care at a glance

283,870

Estimated resident population, 2024

333,619

Registered GP patients, October 2024

31

GP practices

6

Primary Care Networks

51

Community pharmacies, 2025 PNA

1,002,837

GP appointments, April to October 2024

544

Appointments per 1,000 patients, October 2024

971

Primary-care workforce FTE, October 2024

A large primary care population

Brighton & Hove had an estimated resident population of approximately 283,870 in 2024.

The population registered with local GP practices is considerably larger.

NHS Sussex reported that in October 2024 the city's 31 GP practices had 333,619 registered patients, up from 331,127 a year earlier. That represented annual list growth of approximately 0.7%. Practice sizes varied substantially, from around 1,500 registered patients at the smallest practice to more than 31,000 at the largest.

• 31,000+Largest practice list, approximate
• 1,500Smallest practice list, approximate

Registered patients, October 2024, as reported by NHS Sussex.

Registered practice populations and local-authority resident populations are calculated differently and should not be directly equated. Patients can remain registered outside the area in which they are counted as residents, while Brighton & Hove's universities, mobile population and wider travel patterns also influence local primary-care lists.

Nevertheless, the figures demonstrate the scale of the system.

More than 330,000 registered patients create a significant continuing requirement for appointments, medicines, diagnostics, chronic-disease management, preventative care and other community health services.

Six Primary Care Networks organise much of the market

The 31 practices recorded in 2024 were organised into six Primary Care Networks, or PCNs.

• Dean's & Central Brighton PCN
• East & Central Brighton PCN
• North & Central Brighton PCN
• Preston Park Community PCN
• West Hove PCN
• Goldstone PCN

These ranged from Dean's & Central Brighton PCN, with around 35,900 registered patients, to Goldstone PCN, with approximately 81,000. The others were East & Central Brighton, North & Central Brighton, Preston Park Community and West Hove.

PCNs matter because general practice increasingly works at a level larger than the individual surgery.

Practices can share staff, deliver enhanced access collectively and use funding for additional professional roles. For an organisation looking at the primary-care market, the relevant customer, collaborator or commissioning structure may therefore be a PCN or wider neighbourhood partnership rather than an individual practice alone.

The structure is evolving further.

Brighton & Hove is part of the wider move toward Integrated Community Teams, bringing together primary care, community services, mental health, local government, social care and voluntary-sector organisations around local populations.

The current NHS Surrey and Sussex Integrated Care Board describes neighbourhood working as a core part of how health services will develop, with greater emphasis on prevention, integration and care delivered closer to home.

That direction is significant for the future shape of the local market.

GP activity has increased

Primary care in Brighton & Hove is not operating at low activity levels.

Between April and October 2024, local GP practices recorded 1,002,837 appointments, compared with 955,122 during the equivalent period in 2023.

That was an increase of approximately 5%.

Approximate totals for the same seven-month window in each year.

October 2024 alone recorded 181,452 appointments, 10.5% more than October 2023.

Increasing appointment numbers do not necessarily mean access feels easier to patients.

Demand can grow at the same time as capacity.

This is one of the central tensions within modern primary care: practices can provide more appointments than before and still experience significant access pressure because the number and complexity of requests are also changing.

The Brighton & Hove evidence illustrates that clearly.

Access remains a challenge

When NHS Sussex examined GP access in early 2025, Brighton & Hove was delivering fewer appointments per registered patient than the Sussex, South East and England averages.

In October 2024 there were 544 appointments per 1,000 registered patients in Brighton & Hove, compared with 664 across Sussex, 602 across the South East and 607 across England.

1. Brighton & Hove544
2. South East602
3. England607
4. Sussex664

520680

The axis starts at 520 so the differences can be read.

During that month:

• 32.9%Appointments on the day they were booked
• 71.9%Appointments within two weeks of booking

Share of GP appointments, October 2024.

Both measures were below the corresponding England figures for that month.

These figures need careful interpretation.

They are historical access measures from 2024 rather than a real-time assessment of the market in 2026. Different practice populations also have different healthcare needs, and appointment counts do not capture every element of access or quality.

They do, however, explain why improving general-practice access and reducing variation became a specific priority locally.

NHS plans have focused not only on generating more appointments, but on making better use of the capacity already available.

The workforce is becoming broader

One of the biggest changes in primary care is that capacity is no longer determined solely by the number of GPs.

Brighton & Hove's recorded primary-care workforce increased by 67.7 full-time-equivalent posts, or 7.5%, during the year to October 2024, reaching approximately 971 FTE.

The clinical workforce increased by 5%, while the non-clinical workforce grew by 10.6%.

The number of fully qualified GPs also increased. NHS Sussex reported 46.2 fully qualified GP FTEs per 100,000 registered patients, slightly above both the Sussex and England figures used in the comparison.

971

Total workforce FTE, approximate

+67.7

FTE increase in the year to October 2024

+7.5%

Workforce growth in the same period

46.2

Fully qualified GP FTE per 100,000 registered patients

At the same time, PCNs were expanding roles outside traditional general practice.

Growth was reported among:

• Adult mental health practitioners
• Advanced practitioners
• Care coordinators
• First-contact physiotherapists
• Trainee nursing associates
• Digital and transformation staff

This matters commercially because the primary-care workforce is becoming multidisciplinary.

Additional demand does not automatically translate into demand for another GP-led provider.

Some activity can increasingly be handled by pharmacists, physiotherapists, mental health practitioners, nurses, care coordinators or other professionals.

The opportunity may therefore lie in adding a particular capability to the primary-care system, rather than reproducing the traditional practice model.

Mental health creates significant primary-care demand

Brighton & Hove has a particularly important mental-health dimension.

The city's 2025 JSNA reported that 13.4% of adults were recorded on GP depression registers, representing more than 37,000 people, while around 4,500 people were recorded as having severe mental illness.

13.4%

Adults on GP depression registers

37,000+

People on depression registers, approximate

4,500

People recorded with severe mental illness, approximate

The same assessment highlighted higher-than-average mental-health need and substantial inequality in outcomes across the city.

Mental health therefore intersects extensively with general practice.

This is visible in the expansion of mental-health practitioners within PCNs and in newer primary-care-led models.

In March 2026, a new ADHD Primary Care Connect pilot began operating in Brighton & Hove, Crawley and Hastings. The model brings assessment and support for some adults with ADHD closer to primary care rather than relying entirely on conventional specialist pathways.

By August 2026 the programme had received 2,440 referrals across its three pilot areas, demonstrating substantial demand for the pathway.

The significance goes beyond ADHD.

It illustrates a broader shift in which services previously associated mainly with secondary or specialist care may increasingly be organised closer to neighbourhood primary care.

Long-term conditions will place further pressure on the system

Mental health is only one component of future demand.

Brighton & Hove's JSNA estimated that more than 50,900 adults aged 20 and over were living with two or more long-term physical or mental health conditions.

Without stronger prevention, the council projected that more than 10,500 additional adults could be living with two or more long-term conditions by 2030.

50,900+

Adults aged 20 and over today, approximate

with a projected

+10,500

Additional adults by 2030 without stronger prevention

This has substantial implications for primary care.

People living with multiple conditions may require repeated monitoring, medication management, diagnostics, preventative interventions, coordination between specialties, mental-health support, community nursing, rehabilitation and social care interaction.

The resulting demand is not simply a higher number of isolated GP appointments.

It creates a requirement for ongoing, coordinated management across multiple services.

That helps explain why neighbourhood and multidisciplinary models are increasingly central to NHS planning.

Health inequality changes where demand occurs

Brighton & Hove should not be considered a single uniform primary-care market.

There are major differences in health outcomes across a comparatively small geographical area.

The city's JSNA reports a life-expectancy gap of approximately 9.1 years for men and 7.7 years for women between the most and least deprived areas.

9.1 years

Men

and

7.7 years

Women

Multiple long-term conditions are also strongly associated with deprivation.

This means two neighbourhoods with similar population sizes may generate very different healthcare requirements.

East Brighton is an important example.

Whitehawk and surrounding communities experience some of the city's highest levels of deprivation and health inequality. The response has increasingly involved bringing services directly into the community rather than relying exclusively on conventional appointments.

The Whitehawk Health Hub, launched in November 2024, provides an open-access weekly service involving GPs, pharmacists, physiotherapists, mental-health professionals and organisations offering wider support such as housing and benefits advice.

By May 2026, the weekly drop-in had supported 1,269 residents, with more than half reporting that they would otherwise have approached their GP practice.

1,269

Residents supported by the weekly drop-in to May 2026

More than half

Would otherwise have approached their GP practice

That is a useful example of where the local market is heading.

Demand can sometimes be managed more effectively by changing where and how care is provided, rather than simply adding appointments to an existing surgery.

Whitehawk also demonstrates the commissioning dimension

Primary care is not an entirely open commercial market.

NHS GP services operate within contractual and commissioning structures, and opportunities to operate NHS primary medical services can arise through formal procurement.

Whitehawk provides a current local example.

After an earlier procurement process was stopped in July 2025, NHS Surrey and Sussex ICB announced in September 2026 that Wellsbourne Healthcare CIC would continue providing primary medical services under a contract of up to one year from 1 September 2026.

The ICB said it would begin a new procurement process for provision beyond that period while reviewing how future services should meet the needs of the local population.

This is particularly relevant for organisations considering the NHS primary-care market.

An identifiable population need does not mean a provider can simply establish a GP practice and begin receiving NHS-funded patients.

Contracts, commissioning arrangements, procurement rules and local service design determine how much of the market can actually be entered.

Community pharmacy is an increasingly important part of primary care

Brighton & Hove also has a substantial community-pharmacy network.

The city's 2025 Pharmaceutical Needs Assessment recorded 51 community pharmacies, including one distance-selling pharmacy. This equated to 18.2 pharmacies per 100,000 residents, close to the England rate used in the assessment.

Physical access was generally strong.

51

Community pharmacies

18.2

Pharmacies per 100,000 residents

98.1%

Residents who can walk to a pharmacy within 20 minutes

100%

Residents who can reach one within 20 minutes by public transport

The assessment concluded that there were no identified current or projected gaps in necessary pharmaceutical services over its assessment period.

That is important from a market perspective.

Brighton & Hove clearly needs pharmacy services, but the evidence does not indicate a straightforward geographical shortage requiring additional conventional pharmacies.

The more significant development is the widening role of existing pharmacies.

Services such as Pharmacy First, blood-pressure case finding, contraception, vaccination and the New Medicine Service allow community pharmacy to absorb activity that might otherwise fall onto general practice or other NHS services.

Again, the direction is toward greater use of a multidisciplinary primary-care system rather than relying on GP appointments for every healthcare interaction.

Digital access is reshaping general practice

Primary care access is also changing technologically.

The modern general-practice model increasingly combines telephone, online and face-to-face access.

NHS Sussex's Brighton & Hove access work included:

1. 01TelephonyCloud-based telephone systems
2. 02OnlineOnline consultation and digital triage
3. 03NavigationCare-navigation training and access hubs
4. 04DemandBetter demand-and-capacity measurement and administrative automation

The objective is not to replace face-to-face care.

It is to identify the patient's need earlier and direct them to the appropriate response without requiring every request to pass through the same pathway.

For independent health providers, this also changes the competitive landscape.

Patients increasingly expect digital access, rapid triage and clear pathways between online and physical services.

CQC itself now regulates a growing category of online primary-care services carrying out regulated healthcare remotely. Its current guidance includes services providing consultations by video and prescribing following online assessments.

Digital provision therefore creates additional routes into primary healthcare, but it does not remove regulatory responsibilities.

Dentistry is a related but different market

Primary care also extends beyond general practice.

Dental services operate under different contractual and patient-access arrangements, and NHS dental access remains a significant national and local issue.

Brighton & Hove City Council advises residents that dental practices may not be accepting new NHS patients and that people may need to join a waiting list, search more widely or access private treatment.

NHS Surrey and Sussex also maintains urgent dental-care pathways across Brighton & Hove.

The commercial interpretation needs care.

Difficulty obtaining an NHS dentist does not automatically establish that a new dental practice is viable.

NHS dentistry depends heavily on contractual availability and funding, whereas private dentistry operates under different demand and pricing conditions.

A prospective dental provider therefore needs to separate:

population need, unmet NHS demand and commercially accessible demand.

Those are not necessarily the same thing.

Neighbourhood healthcare is becoming more important

Perhaps the most important structural change in Brighton & Hove is the movement toward neighbourhood health.

The current NHS Surrey and Sussex system is explicitly developing services around local communities, with greater integration between general practice, community health, mental health, social care and voluntary organisations.

The model is already visible in East Brighton.

The Whitehawk Health Hub combines clinical and non-clinical support in one community setting, while neighbourhood teams are developing preventative approaches intended to intervene before people's needs escalate.

1. GP practices
2. Primary Care Networks
3. Neighbourhood teams
4. Community providers
5. Wider NHS pathways

This changes how the local primary-care opportunity should be viewed.

The future market is unlikely to consist solely of individual GP surgeries buying isolated services.

Providers may increasingly need to work across that chain.

Understanding where a proposed service sits within that structure will become increasingly important.

What does the Brighton & Hove evidence suggest?

Brighton & Hove has substantial primary-care demand.

Its registered GP population exceeds 330,000, appointment activity has been growing and the number of residents living with multiple long-term physical and mental-health conditions is expected to increase.

But there is little evidence of a simple market-wide shortage that can be solved purely by adding another conventional provider.

Instead, the strongest signals concern:

1. Access and variation

   Improving access and reducing differences between practices, with appointment volumes up but per-patient activity below regional averages in October 2024.

2. Complexity and long-term conditions

   More than 50,900 adults already live with two or more long-term conditions, with further growth projected without stronger prevention.

3. Mental health and neurodevelopment

   High depression-register prevalence and pilots such as ADHD Primary Care Connect show demand for neighbourhood pathways.

4. Multidisciplinary and neighbourhood care

   PCN roles, Integrated Community Teams and hubs such as Whitehawk shift care beyond the traditional surgery model.

5. Digital triage and navigation

   Online access, triage and care navigation are part of how capacity is being used more effectively.

6. Health inequalities

   Large life-expectancy gaps between deprived and less deprived areas change where and how demand presents.

Pharmacy demonstrates the distinction particularly clearly.

There is already good geographical pharmacy coverage, yet pharmacies are being asked to do more.

General practice shows something similar.

The workforce has expanded and appointment volumes have increased, but improving access and using available capacity more effectively remain priorities.

The primary-care opportunity is therefore increasingly about what additional capability a provider can bring to the system, rather than simply whether healthcare demand exists.

Starting or expanding a primary care service in Brighton & Hove

Anyone considering a new primary healthcare service should first establish exactly where it sits within this changing market.

That means understanding:

CQC registers the regulated activities being provided, rather than simply registering a profession or business description. Primary-care providers commonly carry on activities including Treatment of disease, disorder or injury and Diagnostic and screening procedures, while dental services can also involve Surgical procedures.

CQC's current registration guidance states that providers must demonstrate that they are ready to deliver the service and capable of meeting the relevant regulatory requirements before registration is granted.

As with adult social care in Brighton & Hove, registration is therefore only part of the process.

A successful primary-care proposition also needs a clear demand case, a viable route to patients or contracts, an appropriate workforce and a defined place within the wider local healthcare system.

The direction of the Brighton & Hove primary care market

Brighton & Hove is not standing still.

The city's primary-care system is shifting from a model centred primarily on individual GP practices toward a broader network of neighbourhood healthcare.

GP practices remain fundamental, but they increasingly operate alongside pharmacists, mental-health practitioners, physiotherapists, care coordinators, community clinicians, digital services and voluntary organisations.

Current projects in East Brighton and the ADHD Primary Care Connect pilot show how care that might previously have sat elsewhere in the system can increasingly be delivered through or alongside primary care.

For new entrants, that creates both opportunity and complexity.

There is substantial underlying demand, but the strongest proposition may not be another general provider competing for exactly the same activity.

It may be a service that solves a defined capacity problem, improves access for a particular population, moves care closer to home or adds specialist capability to an increasingly integrated neighbourhood system.

That distinction is likely to become more important as Brighton & Hove's population ages, the prevalence of multiple long-term conditions rises and the NHS continues shifting activity from hospitals toward community and primary care.