Primary care in Surrey

Primary care in Surrey operates across one of the largest, wealthiest and most geographically varied county populations in the South East.

More than 1.25 million people now live in Surrey. The population is growing, the number of older residents is increasing and there are substantial differences in health need between affluent communities and the county's more disadvantaged neighbourhoods.

At the same time, primary care is becoming less centred on the traditional GP surgery alone.

General practice increasingly works through Primary Care Networks, multidisciplinary teams and neighbourhood arrangements. Community pharmacy is being used for more clinical activity. Digital access is now routine. Prevention, long-term-condition management and care closer to home are becoming increasingly important.

Surrey is also unusual administratively because not all of the county sits within one NHS commissioning footprint.

Most of Surrey is served by NHS Surrey Heartlands, while parts of the county, including much of Surrey Heath and areas around Farnham, sit within NHS Frimley.

That matters for businesses assessing the local healthcare market.

A service model that fits one part of Surrey may need a different commissioning or referral route elsewhere.

For prospective providers, the central question is therefore not simply whether Surrey has demand for more healthcare.

It is where primary-care capacity, access, prevention and neighbourhood delivery create a genuine route for an additional service.

Surrey primary care at a glance

1,255,255

Estimated Surrey residents in mid-2025

6.9%

Population growth between mid-2015 and mid-2025

25

Primary Care Networks currently identified across Surrey Heartlands

106

GP practices were reported across Surrey Heartlands in the earlier 24-PCN configuration

2025

Surrey's Pharmaceutical Needs Assessment was reopened after a significant series of pharmacy closures

98%

Of pharmacies were reported as signed up to Pharmacy First during the 2025 PNA process

2025

The PNA found no general county-wide gap in necessary pharmaceutical services

These figures come from different reference periods and NHS footprints. They should be read as a description of the structure of Surrey primary care rather than as one live operational dataset.

Surrey's population continues to grow

The latest ONS estimate published through Surrey-i puts Surrey's population at 1,255,255 in mid-2025.

That represents growth of around 0.6% in a single year and 6.9% over the decade from mid-2015.

1. One year to mid-2025

   0.6%

2. Decade from mid-2015 to mid-2025

   6.9%

ONS estimates published through Surrey-i.

Population growth creates more primary-care activity.

More residents generally mean more:

• GP registrations

• appointments

• prescriptions

• vaccinations

• screening

• diagnostics

• long-term-condition reviews

• urgent primary care

• community healthcare

But population size alone is not the most important part of Surrey's demand profile.

Age, deprivation, ethnicity, housing growth and local access all affect the type and intensity of care required.

Ageing will increase complexity as well as activity

Surrey has a slightly older population than England overall.

The proportion aged 65 and over is expected to increase substantially over the coming decades.

That matters because older populations are more likely to require ongoing management of multiple conditions rather than isolated episodes of care.

Primary care may need to coordinate people living with combinations of:

• cardiovascular disease

• diabetes

• respiratory disease

• arthritis

• frailty

• dementia

• kidney disease

• multiple medicines

The challenge is therefore not simply more appointments.

It is more complex patients requiring more coordinated care.

For prospective providers, this creates potential opportunity in areas such as:

• diagnostics

• prevention

• medicines optimisation

• long-term-condition monitoring

• rehabilitation

• frailty support

• community nursing

• proactive case management

But each opportunity still needs a clear referral and funding route.

Surrey does not have one primary-care system

This is one of the most important things to understand before entering the market.

Most of Surrey sits within NHS Surrey Heartlands.

Parts of the county sit within NHS Frimley.

Primary Care Networks, GP practices and commissioning relationships therefore do not map perfectly onto the Surrey County Council boundary.

Current Surrey-i material identifies 25 PCNs within Surrey Heartlands and four Frimley PCNs with patients in Surrey.

25

Within Surrey Heartlands

4

Frimley networks with patients in Surrey

For a provider, this means a county-wide strategy may cross NHS organisational boundaries.

That can affect:

• commissioning

• contracts

• referral pathways

• formularies

• digital systems

• clinical relationships

• neighbourhood structures

A business should identify the actual NHS footprint of its target population before approaching primary care.

Primary Care Networks remain central to neighbourhood delivery

PCNs bring neighbouring GP practices together to serve local populations and organise services at a scale larger than one practice.

They increasingly work with:

• pharmacists

• physiotherapists

• paramedics

• mental-health practitioners

• social prescribers

• care coordinators

• community nursing

• voluntary-sector partners

This changes the route into primary care.

A prospective provider may not need to approach every individual GP practice independently.

Depending on the service, the more relevant relationship may be with:

• a PCN

• a GP federation

• a place partnership

• an ICB

• a neighbourhood team

• a community-service provider

Understanding who controls the pathway is more important than simply identifying which surgery is closest.

General practice demand is increasingly multidisciplinary

Primary care is no longer synonymous with a GP appointment.

National policy and local delivery models increasingly direct patients to the professional best suited to the problem.

That can include:

• clinical pharmacists

• first-contact physiotherapists

• advanced practitioners

• mental-health staff

• care coordinators

• social-prescribing link workers

This creates two important consequences for new providers.

First, evidence that GP practices are busy does not automatically prove demand for another GP-led service.

Second, there may be opportunity for services that remove specific workload from general practice.

The strongest proposition often answers:

What pressure does this service remove, and where does the patient go instead?

Neighbourhood health is becoming more important

The direction of primary care is increasingly toward neighbourhood-based delivery.

The objective is to connect general practice more closely with:

• community health

• adult social care

• mental health

• pharmacy

• voluntary-sector support

• prevention

For Surrey, this is particularly relevant because the county contains large older populations and significant differences in local health need.

A neighbourhood model can respond more precisely than a county-wide one.

For prospective providers, this suggests that successful services may increasingly need to demonstrate integration.

A stand-alone clinic can still be viable.

But a service connected to an existing pathway may have a clearer route to referrals and commissioning.

Health inequalities still matter in an affluent county

Surrey is often characterised as affluent.

That description is broadly true.

It is also incomplete.

The county contains neighbourhoods where residents experience materially worse health and greater barriers to services than the Surrey average suggests.

Surrey's Health and Wellbeing Strategy identifies key neighbourhoods where disadvantage and health need are more concentrated.

This matters because county averages can conceal demand.

A provider assessing Surrey should therefore look below headline indicators.

Conditions associated with deprivation can include higher prevalence of:

• cardiovascular disease

• diabetes

• respiratory disease

• mental-health problems

• smoking-related illness

• obesity

Access barriers can also be greater where households have lower incomes, weaker transport options or lower digital access.

The commercial and clinical opportunity may therefore differ substantially between two areas only a few miles apart.

Prevention is a major strategic direction

Surrey's health system places substantial emphasis on prevention.

This includes earlier identification and management of conditions such as diabetes and cardiovascular disease.

The logic is straightforward.

If people at higher risk can be identified and treated earlier, some future hospital activity and disease progression can be avoided.

For healthcare providers, prevention can create opportunities in:

• screening

• risk assessment

• weight management

• diabetes prevention

• hypertension

• cardiovascular risk

• smoking cessation

• health checks

• medicines optimisation

But prevention has a recurring commercial challenge.

A population may clearly benefit from a service without there being an obvious payer.

The provider still needs to establish whether the model will be:

• NHS commissioned

• subcontracted

• employer funded

• privately funded

• insurance funded

• grant supported

Need and revenue are separate questions.

Long-term conditions create recurring demand

Population ageing and chronic disease mean a growing share of primary-care activity is recurring rather than episodic.

People with diabetes, cardiovascular disease or respiratory conditions may need ongoing:

• monitoring

• review

• medication adjustment

• education

• risk management

• escalation

This can create more predictable service demand than one-off minor illness.

It also aligns well with neighbourhood care because long-term-condition management often spans multiple professionals.

A provider offering recurring support needs to demonstrate:

• clinical governance

• information sharing

• escalation

• continuity

• measurable outcomes

Simply creating another appointment endpoint can fragment care rather than improve it.

Mental health remains part of the primary-care workload

Primary care is often the first point of contact for people experiencing anxiety, depression and other mental-health concerns.

The demand is significant.

But market entry is not as simple as observing that NHS mental-health services are busy.

A new provider needs to understand:

• existing primary-care mental-health provision

• community mental-health services

• NHS referral criteria

• Right to Choose pathways

• local voluntary-sector provision

• risk management

• crisis escalation

The strongest model is likely to be one that fits into the pathway rather than duplicates it.

Community pharmacy is increasingly a clinical service

Community pharmacy is an important part of Surrey's primary-care capacity.

The 2025 Pharmaceutical Needs Assessment was reopened after a substantial number of pharmacy closures since the previous assessment.

That reflects genuine concern about the sustainability and distribution of pharmacy provision.

At the same time, the 2025 PNA concluded that there was not a general county-wide gap in necessary pharmaceutical services.

This is important for prospective entrants.

A series of closures does not automatically mean Surrey needs another pharmacy everywhere.

Pharmacy market entry is regulated and the local PNA is specifically used in decision-making.

The more useful analysis concerns where access problems exist and whether a proposed new pharmacy can satisfy the applicable market-entry test.

Pharmacy First changes how patients enter the system

During the 2025 PNA process, 98% of Surrey pharmacies were reported as signed up to Pharmacy First.

• 98%Signed up to Pharmacy First

The scheme allows community pharmacists to assess and treat defined common conditions without requiring the patient to see a GP first.

This makes pharmacy more relevant to the wider primary-care strategy.

If more low-acuity demand can be managed safely in pharmacy, general practice can focus on people requiring broader assessment or ongoing management.

For providers, it also changes the competitive landscape.

A private minor-illness model needs to account for the fact that some demand may now be handled through NHS-funded pharmacy services.

Pharmacy access is not only about distance

Surrey's 2025 PNA looked at travel times and access across the county.

The Board heard that all areas had pharmacy access within a 30-minute walk and that most residents were within a short drive.

But geographic proximity is only one dimension of access.

Patients can still face barriers caused by:

• opening hours

• mobility

• digital exclusion

• transport

• language

• affordability of non-NHS services

• capacity within the pharmacy

The PNA process also identified Surrey's key neighbourhoods as priorities for advanced and locally commissioned pharmacy services.

That is a useful lesson for wider primary care.

Provision on a map is not necessarily equivalent to practical accessibility.

Pharmacy closures show the importance of commercial sustainability

The 2025 PNA was reopened early because Surrey had experienced a significant number of pharmacy closures after the 2022 assessment.

The discussion around the PNA highlighted financial pressure within community pharmacy.

That matters for anyone assessing the sector.

Strong patient need does not automatically produce a financially sustainable provider model.

Community pharmacy operates within national contractual and reimbursement structures.

A prospective entrant needs to understand those economics before treating a local access concern as a business opportunity.

Housing growth creates pressure on primary-care estate

Surrey continues to experience population and housing growth.

Local planning guidance explicitly recognises the effect this can have on GP capacity.

In parts of the county, practice premises are already constrained.

This creates potential pressure for:

• larger premises

• branch expansion

• neighbourhood hubs

• digital access

• shared clinical space

• community diagnostics

But property should follow the healthcare model.

Securing premises does not create an NHS contract.

A new facility needs a clear relationship with population growth, commissioner priorities and existing estate planning.

Digital access is now normal primary care

Patients increasingly use:

• online consultation

• the NHS App

• remote review

• telephone triage

• electronic prescriptions

• digital monitoring

That creates opportunity for digitally enabled providers.

But digital access is not the same as digital-only care.

Some patients still require:

• physical examination

• diagnostics

• face-to-face assessment

• accessibility adjustments

• non-digital routes

Surrey's inequalities work makes this especially relevant.

A provider should not improve convenience for one group by making access worse for another.

Private primary care is a different market from NHS primary care

Surrey's affluence creates a potentially significant private-pay healthcare market.

Patients may pay for:

• convenience

• speed

• extended appointments

• diagnostics

• screening

• occupational health

• specialist consultations

• services not easily available through the NHS

But private demand should be tested directly.

NHS pressure does not automatically create private customers.

A provider needs to understand:

• willingness to pay

• competitors

• insurance

• customer-acquisition cost

• local demographics

• repeat demand

An NHS subcontracting model and a private-pay clinic may deliver similar clinical services but operate as entirely different businesses.

Workforce remains a limiting factor

Primary care depends on a broad workforce.

That includes:

• GPs

• nurses

• pharmacists

• physiotherapists

• paramedics

• mental-health practitioners

• healthcare assistants

• administrators

• care coordinators

A new service competes for many of the same professionals already required by existing NHS providers.

Surrey's wider labour market can add pressure through high living costs and competition from neighbouring London.

The provider therefore needs to test not only patient demand but clinician supply.

A service cannot solve a capacity problem if it simply moves scarce staff from another part of the same system without increasing productive capacity.

CQC registration depends on what the service actually does

A healthcare business is not automatically CQC regulated simply because it operates a clinic.

Registration depends on the regulated activities carried on.

Depending on the model, these can include:

• Treatment of disease, disorder or injury

• Diagnostic and screening procedures

• Surgical procedures

• Transport services, triage and medical advice provided remotely

• other regulated activities.

The correct registration scope should be mapped from the clinical service.

It should not be inferred from the company name or premises.

Online care still requires robust governance

Digital healthcare can appear simpler to launch because it may not require the same physical estate as a conventional clinic.

That does not remove regulatory or clinical obligations.

Online primary-care models still need to address:

• identity

• consent

• safeguarding

• medicines

• clinical risk

1. 01

   escalation

2. 02

   information governance

3. 03

   quality assurance

Where CQC-regulated activity is being carried on, the provider must also meet the relevant registration requirements.

A digital front end is not a shortcut around a robust operating model.

What does the Surrey primary-care market actually show?

Surrey has substantial healthcare demand.

But the opportunity is more nuanced than "more GPs are needed".

1. 01

   General practice

   Demand will remain high because of population growth, ageing and chronic disease. New services should show how they remove specific workload or integrate into PCN and neighbourhood pathways.

2. 02

   Prevention

   Strong strategic alignment, especially where services identify or manage risk earlier. Funding and referral routes remain essential.

3. 03

   Long-term-condition management

   A growing area because Surrey's ageing population increases multimorbidity. Providers need continuity and integration rather than one-off access.

4. 04

   Community pharmacy

   Increasingly important clinically through Pharmacy First, but the 2025 PNA does not support a simple county-wide shortage narrative.

5. 05

   Mental health

   Substantial need, but providers should map existing NHS and community pathways carefully.

6. 06

   Digital primary care

   Relevant and scalable, particularly for access and monitoring, but it needs safe escalation and non-digital alternatives.

7. 07

   Private healthcare

   Surrey's affluent population can create private demand, but willingness to pay and competition must be tested independently from NHS pressure.

8. 08

   Neighbourhood and community services

   One of the strongest strategic directions. Providers that can reduce hospital dependence and work alongside primary care may be better positioned than disconnected services.

Questions to answer before starting a primary-care service in Surrey

A prospective provider should be able to answer:

Those questions should be answered before significant investment or registration work begins.