Primary Care in Kent: Demand, Access and the Local Market

Kent has one of the largest primary care populations in the South East.

More than 1.65 million people live within the Kent County Council area, excluding Medway. The population has grown by almost 9% over the past decade, and just over one in five residents is already aged 65 or over.

Those figures create substantial underlying healthcare demand.

But Kent's primary care market is not defined by population size alone.

The county contains major commuter towns, expanding housing areas, rural communities, deprived coastal neighbourhoods and some of the more affluent parts of the South East. Health need varies significantly between them.

Primary care is also changing.

General practice remains at the centre of the system, but more care is being delivered through pharmacists, physiotherapists, paramedics, mental health practitioners and other professionals. Primary Care Networks are increasingly moving towards neighbourhood-based models. Community pharmacy is taking on more clinical work, and digital access is changing how patients enter general practice.

For organisations considering entering or expanding within primary care, the relevant question is therefore not simply whether Kent has enough healthcare demand.

It is:

Where does Kent need additional capacity or capability, and how can a new service fit into an increasingly integrated primary care system?

For adult social care and local commissioning pressures, see the companion Kent market reports.

Kent primary care at a glance

1,652,800

Estimated population, Kent County Council area

20.8%

Residents aged 65 and over

251

Community pharmacies, spring 2025

170+

GP practices, Kent and Medway ICB area

1,005

FTE GPs, Kent and Medway, May 2026

70%

Patients rating overall GP experience as good, 2025 survey

49,000+

Pharmacy First referrals by September 2024, Kent and Medway

4,295

People at critical admission-avoidance risk, year to July 2026

A population of more than 1.65 million

Kent County Council's latest population figures put the resident population at approximately 1,652,800.

That makes Kent the largest county council population in the South East.

The population grew by 8.9% between 2015 and 2025, faster than both the South East and England averages over the same period. On current projections, it could increase by a further 8.6% between 2026 and 2041.

1. 2015 to 2025

   +8.9%

2. 2026 to 2041, projected

   +8.6%

Population growth itself creates additional pressure on:

• general practice

• community pharmacy

• dentistry

• diagnostics

• vaccination

• mental health services

• long-term condition management.

But the age profile makes the future challenge more significant.

Approximately 20.8% of Kent residents are aged 65 or over.

The number of people within this age group is projected to increase by 25.3% between 2026 and 2041, compared with growth of only 4.2% among people aged under 65.

That is likely to change not only how much primary care is required but what type.

Ageing means more long-term condition management

Older populations generally have higher rates of long-term illness.

Kent's 2025 Pharmaceutical Needs Assessment estimated that approximately:

1. 105,000

   People living with diabetes

2. 86,000

   Cardiovascular disease

3. 121,000

   Respiratory disease

4. 74,000

   Cancer

5. 14,000

   Dementia

Source: Kent 2025 Pharmaceutical Needs Assessment. Figures describe conditions, not unique individuals.

It also estimated around 227,000 people living with depression and approximately 15,000 with severe mental illness.

These figures describe conditions rather than unique individuals. One person may appear within several categories.

That overlap is precisely why ageing matters.

The future primary care challenge is increasingly one of multimorbidity.

A patient may simultaneously require management for diabetes, hypertension, arthritis, respiratory illness and cognitive decline.

That generates demand for more than isolated GP appointments.

It requires:

• medication management

• monitoring

• diagnostics

• preventative interventions

• care planning

• coordination between services

• community nursing

• social care interaction.

Primary care therefore becomes increasingly important as the part of the healthcare system capable of managing people over time rather than treating single episodes of illness.

Kent is part of a wider Kent and Medway NHS system

There is an important geographical distinction within this report.

The market analysis relates to the Kent County Council area and excludes Medway, because Medway is a separate local authority and will be assessed separately.

NHS primary care commissioning, however, operates across the wider NHS Kent and Medway Integrated Care Board area.

NHS Kent and Medway commissions primary medical, dental, optometry and community pharmacy services across both local-authority areas.

This means some NHS activity and workforce data are published for Kent and Medway together rather than Kent alone.

Where that happens, the distinction matters.

Kent-only population statistics should not be compared directly with Kent-and-Medway healthcare activity as though the geographical boundaries were identical.

General practice is already operating at substantial scale

NHS Kent and Medway currently works with more than 170 GP practices across the combined Kent and Medway system.

Those practices are organised into Primary Care Networks covering Dartford, Gravesham and Swanley, east Kent, west Kent, Swale and Medway.

The scale of activity is substantial.

In July 2025, general-practice teams across Kent and Medway delivered more than 960,000 appointments in a single month, around 3% more than the previous July and almost one-third more than during the equivalent period before the pandemic.

This illustrates one of the central primary-care pressures.

Activity can increase substantially while demand continues to rise alongside it.

Providing more appointments does not automatically mean that patients experience easy access.

The GP challenge is not simply a shortage of doctors

This distinction became particularly clear during an independent review commissioned by NHS Kent and Medway.

The National Association of Primary Care reviewed general practice across the system and concluded that its pressures could not be explained simply by GP numbers.

Instead, the problems reflected a combination of:

1. 01

   Need and complexity

   Increasing patient need and clinical complexity.

2. 02

   Workforce and demand

   Workforce pressures and rising demand.

3. 03

   System and place

   Pressures elsewhere in health and care, and geographical variation between communities.

The review also found that these pressures were unevenly distributed. Some localities faced substantially greater challenges than others.

That is important from a market perspective.

It means the solution is not necessarily another conventional GP provider.

Additional value could come from services that remove particular workloads, improve navigation, manage defined patient groups or increase capacity within neighbourhood teams.

Workforce numbers have been increasing

The system has also continued to add clinical capacity.

In May 2026 there were 1,005 full-time-equivalent GPs across the Kent and Medway ICB area, compared with 933 a year earlier.

That represented an increase of around 72 FTE GPs in 12 months.

933

May 2025

in

1,005

May 2026

The workforce picture is broader than doctors alone.

Primary care increasingly includes:

• clinical pharmacists
• advanced practitioners
• physiotherapists
• paramedics
• mental health practitioners
• social prescribing roles
• care coordinators
• nurses

NHS Kent and Medway's strategy explicitly aims to continue developing multidisciplinary teams so patients can be directed to the clinician best suited to their needs rather than defaulting automatically to a GP.

For prospective providers, that broadens the definition of the primary care market considerably.

Patient experience has improved, but access remains a priority

The 2025 GP Patient Survey found that 70% of patients across Kent and Medway described their overall experience of their GP practice as good, up from 65% in 2023.

That is an improvement.

It does not mean access pressure has disappeared.

The independent general-practice review prompted NHS Kent and Medway to develop a 24-month General Practice Improvement Plan.

Its priorities include:

• improving access and responsiveness

• supporting practices experiencing greater pressure

• stabilising the workforce

• improving digital and telephone systems

• reducing unnecessary workload created between primary and secondary care

• strengthening neighbourhood health services.

This gives prospective healthcare providers a useful indication of where the system sees its current problems.

The opportunity is increasingly about improving how capacity works rather than simply increasing provider numbers.

Primary Care Networks are becoming neighbourhood health organisations

One of the most significant developments occurred in 2026.

Every GP practice across Kent and Medway agreed to participate in a new Single Neighbourhood Health Offer.

The arrangement uses existing Primary Care Network structures to create more coordinated GP-led neighbourhood care for people with the most complex needs.

NHS England approved a local variation to the national PCN contract, unlocking nearly £10 million of additional annual investment.

More than 170 practices signed up.

This is particularly important for understanding where Kent primary care is heading.

The model is intended to bring together different professionals around populations rather than relying on fragmented services.

For providers, this changes the potential route into the market.

Instead of thinking only:

Which GP practice could buy this service?

the question may increasingly become:

Where does this service fit within a neighbourhood pathway?

Complex patients are an explicit neighbourhood priority

Neighbourhood working is particularly focused on people whose needs cross multiple organisations.

These may include people with:

• several long-term conditions

• frailty

• complex mental health needs

• high risk of hospital admission

• combined health and social care requirements.

NHS Kent and Medway already uses population-health risk stratification to identify patients most likely to require additional intervention.

For the year to 31 July 2026, its system had identified 4,295 people at critical risk of avoidable admission and another 10,261 within its significant admission-avoidance category across Kent and Medway.

4,295

Critical admission-avoidance risk

10,261

Significant admission-avoidance category

That illustrates another important direction.

Primary care is moving from waiting for people to become ill toward identifying those most likely to deteriorate and intervening earlier.

Prevention is likely to become a larger part of the market

This shift aligns closely with Kent County Council's own public-health and prevention work.

The county has significant levels of cardiovascular disease, diabetes, respiratory disease, obesity and smoking-related illness.

Some of these conditions can be prevented or their progression delayed through:

• earlier diagnosis
• blood-pressure management
• weight management
• smoking cessation
• medication optimisation
• physical activity
• vaccination
• screening

Primary care is therefore likely to be increasingly judged not only by how quickly it responds to illness but by whether it prevents future deterioration.

For healthcare providers, that potentially expands demand for services able to demonstrate measurable preventative outcomes.

Community pharmacy is becoming clinical capacity

Kent also has a substantial community pharmacy network.

The final Kent Pharmaceutical Needs Assessment 2025-2028 recorded 251 community pharmacies, including two distance-selling pharmacies, as of spring 2025.

There were also 41 dispensing GP practices operating through 44 sites.

The number of community pharmacies had fallen from 272 at the time of the previous PNA.

Despite that reduction, the 2025 assessment concluded that there remained adequate access to necessary pharmaceutical services across Kent, taking account of pharmacies, dispensing practices and neighbouring provision.

That distinction matters.

The evidence does not indicate a simple county-wide need to open more conventional pharmacies.

The stronger development is what existing pharmacies are being asked to do.

Pharmacy is increasingly taking work from general practice

NHS Kent and Medway's primary care strategy explicitly identifies greater use of community pharmacy as one way of managing pressure on general practice.

That transition was already visible after the launch of Pharmacy First.

By September 2024, more than 49,000 Pharmacy First referrals had been made across Kent and Medway, and 98% of community pharmacies were offering the service.

Large numbers of pharmacies were also delivering blood-pressure case finding, contraception and other advanced clinical services.

The direction is clear.

Community pharmacy is moving further into the clinical primary-care pathway.

For patients, that can improve access.

For GP practices, it can remove activity that does not necessarily require a doctor.

For pharmacy operators, it changes the commercial and workforce requirements of running the service.

Geography still matters for pharmacy access

Kent's pharmacy network also illustrates the county's urban-rural divide.

The Pharmaceutical Needs Assessment found that pharmacies are generally concentrated in areas with greater population density.

Dispensing GP practices play a more important role in rural communities.

Kent had 15.6 community pharmacies per 100,000 residents in the 2025 assessment, below the England average of 18.1, although the PNA cautions against making a simple comparison because Kent's rural dispensing practices supplement pharmacy access.

Opening hours also vary.

In 2025:

The primary care challenge is therefore not always whether a service exists.

It can be whether it is available at the time and in the location where people need it.

Health inequalities are especially important in coastal Kent

Kent's average health indicators conceal significant local inequality.

The latest deprivation data show that Thanet is within the 10% most deprived local-authority areas in England.

Dover, Folkestone and Hythe, Swale and Thanet are all within the 30% most deprived local authorities nationally.

Kent's public-health evidence also shows higher burdens of several conditions in these communities.

Thanet and Dover have comparatively high respiratory-disease prevalence.

Cardiovascular disease is more prevalent in Thanet, Swale and Dover, while diabetes prevalence is particularly high in Gravesham, Dartford, Swale, Thanet and Maidstone.

These differences have major implications for primary care.

A provider looking only at county averages risks missing where need is actually concentrated.

Coastal Kent is now being treated as a specific health-inequality region

Kent has gone further by establishing a Marmot Coastal Region programme covering:

• Swale
• Canterbury
• Thanet
• Dover
• Folkestone and Hythe
• Ashford

The programme was developed with the UCL Institute of Health Equity to address the social and economic causes of health inequality rather than relying solely on healthcare interventions.

This matters commercially as well as clinically.

The areas with the highest level of health need may not necessarily have the greatest private purchasing power.

In deprived communities, NHS commissioning and integration with existing pathways may matter far more than private-pay demand.

Primary care access is also affected by rurality

Kent's rural communities create a different access problem.

Some residents have longer journeys to GP surgeries, pharmacies, diagnostics and community clinics.

Public transport can also be more limited.

Digital access can reduce some of the inconvenience, but it does not eliminate the need for physical healthcare.

This creates potential value in models that move clinical activity closer to patients through:

• community locations

• mobile services

• neighbourhood hubs

• remote monitoring

• home-based care.

Again, the opportunity is not necessarily a new conventional practice.

It may be a different delivery model for existing primary-care activity.

Local diagnostics can relieve wider system pressure

The introduction of a new blood-testing service in Deal illustrates this.

In October 2025, Kent Community Health NHS Foundation Trust began providing additional community phlebotomy at Victoria Hospital in Deal.

The service supplemented blood testing already available through GP practices and included capacity for urgent testing, difficult venepuncture and other specialist requirements.

This is a useful example of how local primary-care capacity can be strengthened.

The solution to pressure on general practice does not always require increasing GP numbers.

Moving diagnostics or other procedures into accessible community settings can release capacity elsewhere in the system.

Dentistry remains a significant access issue

NHS dentistry sits within primary care but operates under a different commercial and contractual model.

Kent and Medway have continued to experience problems around NHS dental access.

The ICB has reviewed contracts where dental providers were significantly underperforming against commissioned activity, with the intention of reallocating funding to increase capacity.

It has also funded recruitment support in harder-to-staff areas including Canterbury, Folkestone and Hythe, Swale, Thanet and Dover.

In January 2026, additional urgent dental appointments also became available across Kent and Medway through a centralised access route.

The commercial interpretation requires care.

Difficulty obtaining an NHS dentist clearly indicates unmet health need.

It does not automatically mean a new dental practice can access an NHS contract.

NHS dental need and private dental demand are different markets

A prospective dental operator needs to distinguish between three things:

These groups overlap.

They are not identical.

NHS dental provision depends on commissioning and contractual arrangements.

Private dentistry is much more directly influenced by local income, demographics, competition and customer acquisition.

This distinction is particularly relevant within Kent because purchasing power differs substantially between communities.

A strong NHS-access problem in a deprived coastal district does not automatically create an equally strong private-pay market.

Mental health increasingly interacts with primary care

Mental health is another major component of the local primary care workload.

Kent's population evidence estimates around 227,000 people living with depression and approximately 15,000 with severe mental illness.

Mental health pathways increasingly interact directly with general practice and PCNs.

Kent and Medway Mental Health NHS Trust, for example, provides PCN-linked mental-health practitioner support in parts of Kent, helping patients whose difficulties can be managed within or alongside primary care rather than relying solely on traditional specialist pathways.

This is consistent with the wider neighbourhood direction.

Primary care increasingly acts as the point at which physical health, mental health and social need meet.

Estates can constrain primary care growth

Buildings are another part of the capacity problem.

NHS Kent and Medway's primary care strategy specifically identifies fit-for-purpose general-practice premises as critical to service sustainability.

Population growth can create pressure on practices even where workforce recruitment is successful if the physical estate does not provide enough consultation rooms or appropriate clinical space.

This is particularly relevant in areas experiencing substantial housing growth.

Additional residents can arrive much faster than new healthcare infrastructure.

For prospective providers, estate constraints can sometimes create opportunities for alternative premises, community hubs or services that can operate outside conventional GP surgery space.

Digital access is now part of primary care infrastructure

Technology is also becoming central to how practices manage demand.

NHS Kent and Medway's strategy identifies online consultations, video consultation, improved websites, digital appointment access and modern telephone systems as important parts of improving access and practice resilience.

But the ICB also explicitly recognises the risk of digital exclusion.

Older people, people with disabilities, people without reliable internet access or those who struggle with digital systems still need viable alternative routes.

The future primary care model is therefore unlikely to be purely digital.

The aim is increasingly:

digital where useful, face-to-face where necessary, and better navigation between the two.

What does the Kent evidence suggest?

Kent has very substantial underlying primary care demand.

The county has more than 1.65 million residents, continuing population growth, an ageing population, significant levels of chronic disease, marked health inequality between communities, and major rural and coastal access differences.

But this does not establish a simple shortage of conventional primary care businesses.

The system already contains a large GP network and 251 community pharmacies, alongside dentistry, optometry, community healthcare and other services.

The clearer signals concern how care is organised and where specific gaps remain.

Current priorities include:

These areas potentially create opportunities for new providers.

But each needs to be tested against the way the NHS actually purchases and refers care.

Starting a primary care service in Kent

A prospective healthcare provider should begin with the pathway rather than the registration.

The important questions are:

Primary care services may require CQC registration for activities including Treatment of disease, disorder or injury, Diagnostic and screening procedures or other activities depending on the service model.

But registration is only one part of market entry.

It does not create an NHS contract, patients or referrals.

The step-by-step CQC registration guide sets out the registration process.

Kent's primary care market is becoming more integrated

The clearest direction in 2026 is toward neighbourhood health.

Every GP practice within the wider Kent and Medway system has now signed up to the Single Neighbourhood Health model, with significant new investment attached to proactive multidisciplinary care for people with complex needs.

That is likely to influence how future services are commissioned.

Providers may increasingly need to show that they can integrate with existing teams, share information appropriately, manage defined populations, demonstrate outcomes and reduce demand elsewhere in the system.

The proposition therefore becomes less:

"We can provide this clinical service."

And more:

"We can solve this specific primary-care problem within this neighbourhood or patient pathway."

For Kent, with its large population and major differences between localities, that distinction is particularly important.