Primary Care in East Sussex: Demand, Access and the Local Market

Primary care in East Sussex serves a growing and unusually old population, with demand for general practice continuing to increase.

But understanding the local primary-care environment requires more than counting GP surgeries. Practice size varies considerably, millions of appointments are delivered each year, multidisciplinary teams are expanding, and access and population need differ across the county.

This report looks at the scale and structure of primary care in East Sussex, how demand is changing, and some of the pressures shaping the local market.

East Sussex primary care at a glance

50

GP practices

591,000

Registered GP patients, approximately

12

Primary Care Networks

94

Community pharmacies

1

Primary Care Hub

3.77m

GP appointments in 2024/25

4.2%

Appointment growth in 2024/25

351

ARRS workforce, whole-time equivalent, approximately

26.6%

Population aged 65+

As of August 2025, East Sussex had 50 GP practices organised into 12 Primary Care Networks. The registered patient population was around 591,000 in July 2025. Individual practice list sizes ranged from approximately 2,840 patients to more than 28,500.

Fifty GP practices does not mean fifty equivalent markets

GP practices in East Sussex differ substantially in scale.

The largest practice list reported by NHS Sussex was approximately 28,553 patients, while the smallest was around 2,840.

• 28,553Largest practice list
• 2,840Smallest practice list

Approximate registered patients, as reported by NHS Sussex.

This illustrates why simply using the number of GP practices as a measure of primary-care supply can be misleading.

A more useful assessment should consider:

• registered patients;
• practice list size;
• appointments delivered;
• clinical workforce;
• wider multidisciplinary staffing;
• population health needs;
• estate capacity;
• and geographical accessibility.

The 50 practices are grouped into 12 Primary Care Networks, which allow neighbouring practices to share resources and deliver services across larger patient populations. East Sussex also increasingly uses five wider neighbourhood footprints corresponding broadly with Lewes, Wealden, Eastbourne, Hastings and Rother.

• Lewes
• Wealden
• Rother
• Eastbourne
• Hastings

English Channel

Districts are shown in their rough positions, not to scale.

Demand for general practice is substantial and continuing to grow

During 2024/25, GP practices in East Sussex delivered 3,771,179 appointments.

That was 4.2% more than the previous year, while NHS Sussex exceeded its overall operating-plan target for GP appointments by 11.5%.

That equates to more than 300,000 appointments during an average month.

3,771,179

Appointments delivered in East Sussex

+4.2%

Year-on-year appointment growth

300,000+

Appointments in an average month

11.5%

NHS Sussex appointments above operating-plan target

The previous year's data also showed East Sussex providing a relatively high volume of appointments in population terms. In July 2024, practices delivered approximately 537 appointments per 1,000 registered patients, compared with 517 across Sussex as a whole, 500 nationally and 483 across the South East.

1. East Sussex537
2. Sussex517
3. England500
4. South East483

450550

The axis starts at 450 so the differences can be read.

The more recent 2025 update shows the same underlying pattern. In June 2025, East Sussex delivered around 531 appointments per 1,000 registered patients, compared with 516 across Sussex, 469 across the South East and 478 nationally.

Activity in the first three months of 2025/26 was lower than the same period a year earlier overall, but the monthly position improved by June. NHS Sussex said it was not forecasting a negative position against its 2025/26 plan.

This does not mean every resident experiences access in the same way.

It does show that East Sussex general practice continues to handle a high volume of activity relative to population.

East Sussex's population creates particular primary-care pressures

East Sussex has an older population than England overall.

Approximately 26.6% of residents are aged 65 or over, compared with less than one-fifth nationally. The oldest age groups are also projected to grow particularly quickly.

26.6%

East Sussex

against

Under 1 in 5

England

An ageing population is relevant to primary care because older people are more likely to live with multiple long-term conditions and require continuing management rather than isolated episodes of treatment.

NHS Sussex identifies growing multimorbidity, increasing complexity of physical and mental health needs and changing patient expectations among the factors increasing demand on general practice.

The relationship is not simply that an older population requires more GP appointments.

It also changes what primary care needs to provide, including chronic-disease management, medicines support, prevention, frailty services and coordination with community, hospital and social-care services.

Access is about capacity and variation

High appointment volumes do not automatically produce consistent patient access.

In July 2024, 43.2% of East Sussex GP appointments took place on the same day they were booked, while 79.5% took place within two weeks.

• 43.2%Appointments on the day they were booked
• 79.5%Appointments within two weeks of booking

Share of GP appointments, July 2024.

East Sussex's Health Overview and Scrutiny Committee has repeatedly examined differences between practices, including variation in online access, appointment availability and how patients interact with their surgeries.

NHS Sussex has described reducing this unwarranted variation as an important part of its primary-care improvement work.

This matters when analysing the local primary-care market.

Two areas with similar populations and similar numbers of GP practices may have very different levels of actual capacity depending on practice size, staffing, estates and operating model.

The primary-care workforce is becoming broader than GPs and nurses

One of the most significant changes in general practice has been the growth of multidisciplinary primary-care teams.

The Additional Roles Reimbursement Scheme allows Primary Care Networks to employ professionals including:

• Clinical pharmacists
• Physiotherapists
• Paramedics
• Mental-health practitioners
• Social-prescribing link workers
• Care coordinators
• Occupational therapists
• Podiatrists
• Physician associates
• Advanced practitioners

By July 2024, the East Sussex ARRS workforce had reached approximately 350.7 whole-time-equivalent staff, an increase of around 24.7 WTE in a year.

350.7

Whole-time-equivalent staff

+24.7

Whole-time-equivalent increase on the previous year

Earlier workforce data also showed growth in the core practice workforce. Between April 2023 and March 2024, GP capacity increased from approximately 231.5 to 254.6 FTE, while nursing capacity increased from approximately 172.9 to 187.7 FTE.

• GPs
• Nurses

Approximate FTE at the two published dates. The line joins them and does not show the months between.

The direction of primary care is therefore towards a wider team model rather than an assumption that every additional unit of demand must be met by another GP.

Community pharmacy is taking on a larger role

The local primary-care system extends beyond GP surgeries.

East Sussex had 94 community pharmacies in August 2025, compared with 50 GP practices.

Services such as Pharmacy First are designed to allow people with certain conditions to receive assessment and treatment directly from community pharmacy rather than entering general practice first.

In July 2024 alone, 520 East Sussex patients were referred to pharmacies through Pharmacy First pathways.

94

Community pharmacies, August 2025

50

GP practices, August 2025

520

Pharmacy First referrals, July 2024

This means that analysing future primary-care need increasingly requires looking at the whole local system, rather than GP practices in isolation.

The 2025 East Sussex Pharmaceutical Needs Assessment also shows why simple pharmacy counts are not enough. Resident feedback suggested access was strongest during conventional weekday opening hours and materially weaker in evenings, weekends and bank holidays. Geography matters too: people in rural districts are more likely to depend on cars, and public-transport use for pharmacy access was particularly low in Rother and Wealden.

So pharmacy capacity is not only about how many pharmacies exist. Opening hours, transport, location and the range of services provided can all affect effective access.

NHS dentistry is a separate access problem

Dentistry sits alongside general practice and community pharmacy within the wider primary-care system, but its market and access pressures are different.

East Sussex Health Overview and Scrutiny Committee has repeatedly considered difficulties in accessing NHS dentistry. NHS Sussex has been trying to increase both routine and urgent capacity, including additional-hours schemes, urgent dental care and stabilisation programmes, temporary increases in contracted activity and incentives intended to attract dentists into areas with weaker provision.

The local picture is not uniform.

Lewes has previously been identified as an area where commissioned dental activity had fallen below the Sussex average for areas with similar levels of deprivation. NHS Sussex responded by offering temporary increases in Units of Dental Activity to local providers.

Rother presents a different access challenge. In March 2025, NHS Sussex told the scrutiny committee that it had not yet identified a provider willing to deliver its Urgent Dental Care and Stabilisation Programme in Rother, despite interest elsewhere in the county. Geography and travel therefore matter alongside the overall volume of dental activity.

Hastings has also been a focus for additional access activity, reflecting a combination of deprivation, oral-health need and pressure on NHS provision.

This makes dentistry relevant to any assessment of the East Sussex primary-care market, but it should not be treated as simply another part of the GP market. Dental commissioning, workforce, contracts and private-pay behaviour operate differently.

For a prospective provider, the important question is therefore not whether East Sussex has "enough dentistry" at county level. It is where access is weakest, what type of activity is commissioned, what workforce can be recruited and whether the intended model is NHS-funded, private or mixed.

Primary care is becoming more neighbourhood-based

The organisational direction of travel is towards greater integration between general practice, community health, mental health, social care, pharmacy and voluntary-sector services.

East Sussex has five Integrated Community Team areas aligned broadly with Eastbourne, Hastings, Lewes, Rother and Wealden.

NHS Sussex describes Primary Care Networks as an important part of the "front door" to this more integrated neighbourhood model.

1. 01Practices50 GP practices, each with its own registered list
2. 02Networks12 Primary Care Networks sharing staff and services
3. 03NeighbourhoodsEastbourne, Hastings, Lewes, Rother and Wealden
4. 04Wider servicesCommunity health, mental health, social care, pharmacy and the voluntary sector

For local market analysis, this potentially gives a more meaningful geography than considering East Sussex solely as one county-wide market.

The needs of Hastings, for example, are not necessarily the same as those of Rother or Wealden.

Health inequalities mean local demand is not evenly distributed

East Sussex contains significant differences in age, deprivation and health outcomes.

Hastings experiences materially different health inequalities from some of the more affluent parts of the county, while Rother has a particularly old population and rural areas create different accessibility challenges.

NHS Sussex states that all East Sussex PCNs are undertaking multi-agency work focused on neighbourhood health inequalities.

This is important when considering primary-care provision.

Areas with identical population sizes may produce different levels and types of demand because of:

• age;
• deprivation;
• prevalence of long-term conditions;
• mental-health need;
• transport;
• rurality;
• and patterns of service use.

• Lewes
• Wealden
• RotherA particularly old population
• Eastbourne
• HastingsMaterially different health inequalities from more affluent parts of the county

English Channel

Rural areas across the county create different accessibility challenges. Districts are shown in their rough positions, not to scale.

What does the East Sussex primary-care market show?

East Sussex is not experiencing one simple primary-care shortage that can be understood by comparing population with the number of surgeries. General practice, pharmacy and dentistry each have different capacity and access pressures.

Growing activity

Nearly 3.8 million GP appointments were delivered in 2024/25, with activity increasing year on year.

An ageing population

Increasing the prevalence and complexity of long-term healthcare needs.

Large differences in practice scale

Patient lists range from fewer than 3,000 to more than 28,000.

A changing workforce

Multidisciplinary PCN teams are becoming an increasingly important part of capacity.

Variation in access

Appointment volume is high, but patient access and operating models differ between practices.

Greater integration

Primary care is increasingly being organised around neighbourhood systems rather than standalone GP surgeries.

Different local needs

Hastings, Rother, Eastbourne, Lewes and Wealden should not automatically be treated as identical healthcare markets.

Dental and pharmacy access

Also vary by locality, opening hours, transport and commissioned capacity.