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

Primary care in West Sussex operates in one of the larger and more geographically varied primary care markets in the South East.

More than 915,000 people live in the county, its population is growing, and almost a quarter of residents are already aged 65 or over. At the same time, West Sussex contains densely populated coastal towns, affluent inland communities, significant rural areas and a younger, more diverse population around Crawley.

Those differences create very different demands on primary care.

An ageing population increases requirements for long-term condition management, medicines, diagnostics and preventative healthcare. Population growth adds further activity. Health inequalities create more concentrated need within particular communities, while rural geography can make access more difficult even where services exist.

Primary care itself is also changing.

General practice increasingly operates through Primary Care Networks and multidisciplinary teams rather than GP consultations alone. Community pharmacies are providing more clinical services. Digital access and care navigation are changing how patients enter the system. NHS strategy is increasingly focused on prevention and delivering more healthcare in neighbourhood and community settings rather than hospitals.

For organisations considering entering or expanding within the primary care market, the opportunity is therefore broader than simply asking whether West Sussex needs more GP appointments.

The more important question is:

Where does the health system need additional capacity, capability or access, and how could a new service fit into the way primary care is now being organised?

For adult social care and neighbourhood independence, see the companion West Sussex market reports.

West Sussex primary care at a glance

915,037

Estimated population, ONS mid-2024

23%

Population aged 65 and over, 2024

74

GP practices

21

Primary Care Networks

142

Community pharmacies, 2025 PNA

57%

Sussex GP appointments not delivered by a GP, June 2025

1m+

Sussex GP appointments in September 2025 alone

94%

Sussex GP practices on cloud telephony, April 2025

A growing population of more than 915,000 people

The latest ONS estimates put the West Sussex population at 915,037 in 2024, an increase of approximately 11,000 people in a single year.

Between mid-2021 and mid-2024, the county's population increased by approximately 3.4%.

915,037

Estimated population, 2024

and

3.4%

Growth between mid-2021 and mid-2024

Recent growth has been driven by migration rather than natural population change. In 2024 there were approximately 7,700 births and 9,700 deaths, while inward migration more than offset that natural decline.

7,700

Births

against

9,700

Deaths

Population growth alone creates additional primary care demand.

More residents mean more:

• GP registrations
• Consultations
• Prescriptions
• Vaccinations
• Screening
• Diagnostics
• Chronic disease monitoring
• Urgent primary care
• Community health activity

But West Sussex's age structure is especially important.

The median age in 2024 was 44.7 years, compared with 40.2 across England. Around 23% of the population is aged 65 or over, and the county's older population is projected to continue increasing.

1. 40.2England
2. 44.7West Sussex

That changes both the volume and nature of primary care demand.

Ageing creates more than additional appointments

Older populations generally make greater use of healthcare.

But the more important issue for West Sussex is the increasing prevalence of multiple conditions within the same individual.

Local modelling suggests that by 2035 the number of people living with dependency needs will increase substantially, particularly among the oldest age groups.

West Sussex's JSNA modelling estimates that there could be:

+16,700

People with low dependency needs

+3,700

People with medium or high dependency

+5,700

People with dementia and at least two other long-term conditions

Projections rather than precise forecasts. The dementia multimorbidity figure is about 71% above the 2022 baseline used in the modelling.

These are projections rather than precise forecasts, but the direction matters.

Primary care increasingly needs to manage patients with combinations of conditions rather than isolated illnesses.

A person may simultaneously be living with diabetes, cardiovascular disease, arthritis, dementia and medication-related risks.

That creates demand for:

• monitoring
• medication review
• proactive case management
• diagnostics
• prevention
• care coordination
• community nursing
• rehabilitation
• social care interaction.

The future primary care challenge is therefore not simply more patients.

It is more complex patients requiring more coordinated care.

West Sussex has an extensive general practice structure

Primary care across West Sussex is already delivered through a large network of practices and Primary Care Networks.

Recent Sussex primary care information lists 74 GP practices operating through 21 Primary Care Networks in West Sussex.

PCNs group practices together around populations and increasingly allow services to operate at a scale larger than one individual surgery.

Nationally, PCNs typically cover populations of around 30,000 to 50,000 people, although local arrangements vary. Their purpose is to allow practices to collaborate with community health, mental health, pharmacy, social care and voluntary organisations while providing more proactive and coordinated care.

That matters for organisations assessing the primary care market.

The relevant route into the system may not always be an individual GP practice.

Depending on the service, it could involve:

1. Practice
2. PCN
3. Locality
4. Neighbourhood partnership
5. Wider NHS commissioner

Understanding that structure is increasingly important for businesses that want to work alongside NHS primary care.

• Adur
• Arun
• Chichester
• Crawley
• Horsham
• Mid Sussex
• Worthing

West Sussex locality primary care leadership covers these areas within the Sussex Primary Care Provider Collaborative.

GP capacity is increasingly multidisciplinary

The modern GP practice is no longer staffed only by doctors, nurses and reception teams.

Primary care across Sussex has been expanding the range of professionals working within practices and PCNs.

In June 2025, 57% of general practice appointments across Sussex were delivered by professionals other than GPs, including advanced nurse practitioners, physiotherapists, clinical pharmacists, mental health care coordinators and other members of the wider primary care team.

By March 2025, Sussex PCNs had more than 1,050 whole-time-equivalent additional roles supported through the Additional Roles Reimbursement Scheme and associated workforce programmes.

57%

Sussex appointments not delivered by a GP, June 2025

1,050+

Additional PCN roles, whole-time equivalent, March 2025

That changes how additional capacity can be created.

Rising demand does not necessarily mean every additional patient needs another GP appointment.

Some needs may be more appropriately addressed by:

• Clinical pharmacists
• Physiotherapists
• Paramedics
• Mental health practitioners
• Social prescribers
• Advanced practitioners
• Care coordinators

The current NHS Surrey and Sussex GP guidance explicitly describes general practice as a multidisciplinary service and encourages patients to see the professional best suited to their need.

For prospective providers, this broadens the primary care market considerably.

The opportunity may be to add a particular clinical capability rather than reproduce the traditional GP surgery model.

Appointment demand remains substantial

Across Sussex, general practice is already delivering very high volumes of activity.

More than one million GP practice appointments were delivered during September 2025 alone, following another month above one million in July.

September's activity included approximately:

• 582,000Face-to-face appointments
• 260,000Telephone appointments
• 116,000Video or online consultations
• 11,000+Home visits

Sussex-wide figures. They show the operating environment, not a direct West Sussex activity total.

These are Sussex-wide rather than West Sussex-only figures and should not be presented as a direct measure of West Sussex activity.

They demonstrate the wider operating environment.

Primary care activity is already substantial, yet improving access remains a major NHS priority.

This apparent contradiction is important.

A health system can deliver more appointments while patients continue to experience access difficulties because demand grows at the same time.

The problem therefore cannot always be solved by adding appointments alone.

Access increasingly means directing patients to the right service

The NHS's current primary care strategy is placing considerable emphasis on better navigation.

For 2026/27, Sussex commissioning intentions require PCNs to improve access through:

• Telephone, online and in-person contact routes
• Structured information gathering
• Consistent care navigation
• Prioritisation based on clinical need rather than simple first-come-first-served access
• Greater use of multidisciplinary primary care teams
• Greater use of community and self-access services where appropriate

The objective is effectively to make better use of available clinical capacity.

A patient requesting a GP appointment may actually require a pharmacist, physiotherapist, nurse, mental health practitioner or another service.

That creates opportunities for services capable of removing activity from traditional general practice while still delivering safe and appropriate care.

It also means the commercial case for a new primary care service should identify what pressure it removes from the existing pathway.

Simply demonstrating that GP practices are busy is not enough.

Digital access is now part of the core model

Primary care access has also become increasingly digital.

Across Sussex, 94% of GP practices had moved onto modern cloud-based telephone systems by April 2025, while online consultation tools, the NHS App and digital triage have become increasingly important access channels.

• 94%Sussex GP practices on cloud-based telephone systems

Sussex-wide.

The new NHS Surrey and Sussex ICB describes both digital-first access and neighbourhood-based care as major components of its future commissioning strategy.

Digital access does not eliminate the need for physical healthcare.

Many patients still require examination, diagnostics or face-to-face assessment.

It does, however, change how demand is filtered and how services can be delivered.

For providers, that means future primary care models may combine:

1. Digital entry
2. Remote assessment
3. Community intervention
4. Face-to-face escalation where necessary

This potentially opens the market to different operational models from conventional premises-based primary care.

Health inequalities mean demand is not evenly distributed

West Sussex performs comparatively well on many overall health measures.

But county averages conceal substantial differences.

More than a third of West Sussex residents live in coastal communities, and the county's current coastal health inequalities work concludes that these populations experience poorer health outcomes than non-coastal areas.

Coastal areas including Bognor Regis, Littlehampton, Selsey, Worthing, Shoreham and other communities generally contain older populations and higher levels of deprivation than many inland parts of the county.

The same evidence finds a higher burden of disease within coastal communities.

West Sussex also contains deprived neighbourhoods elsewhere, including parts of Crawley.

This matters because primary care demand is influenced by more than population size.

Communities experiencing greater deprivation can have higher prevalence of:

• cardiovascular disease
• respiratory illness
• diabetes
• mental illness
• smoking-related disease
• multimorbidity.

They can simultaneously face greater barriers to accessing preventative healthcare.

The result is that two similarly sized populations may require very different levels and types of primary care.

Prevention is becoming more commercially and clinically important

The newly created NHS Surrey and Sussex ICB has made prevention one of the central themes of its five-year commissioning approach.

Its current strategy identifies cardiovascular disease, diabetes, respiratory disease, obesity, chronic kidney disease, anxiety and depression among the conditions driving substantial future demand.

The planned response includes expanding prevention and early intervention while moving more care from hospitals into neighbourhood and community settings.

There is already evidence of this approach.

A Sussex cardiovascular disease prevention programme used primary care data to identify people who had not yet been offered indicated treatment.

Across 148 practices, more than 13,600 patients were offered therapy and more than 5,400 initiated treatment.

13,600+

Patients offered therapy

with

5,400+

Patients who initiated treatment

That illustrates an important change in primary care.

Rather than waiting for people to present when disease has progressed, services are increasingly expected to identify risk and intervene earlier.

For new healthcare providers, preventative services may therefore become increasingly relevant where they can demonstrate measurable impact on future demand.

Neighbourhood health is changing how primary care fits together

The structural direction of the NHS is also shifting toward neighbourhood delivery.

On 1 April 2026, NHS Sussex and NHS Surrey Heartlands merged to create NHS Surrey and Sussex Integrated Care Board, which is now responsible for planning and buying healthcare across the wider Surrey and Sussex geography.

Despite the larger commissioning footprint, the ICB says much of the practical transformation will take place locally at neighbourhood level.

Its model emphasises partnerships between:

• primary care
• community healthcare
• mental health services
• local authorities
• voluntary and community organisations
• other care providers.

West Sussex is already represented within the Sussex Primary Care Provider Collaborative and has locality primary care leadership covering Adur, Arun, Chichester, Crawley, Horsham, Mid Sussex and Worthing.

This is a significant development for the provider market.

A service that once might have approached individual GP practices separately may increasingly need to demonstrate how it contributes to a wider neighbourhood pathway.

Crawley illustrates the different West Sussex demographic

It is particularly important not to assume that the whole county looks like its older coastal areas.

Crawley has a younger and substantially more ethnically diverse population.

38%

Crawley population

compared with

16%

West Sussex overall

Crawley also has a younger age profile.

That produces a different pattern of primary care need from areas with much larger older populations.

Healthcare provision may need to respond differently to:

• maternity and family health
• working-age population health
• cultural and language needs
• mental health
• preventative care
• employment-related health pressures.

This reinforces the need to assess West Sussex below county level.

A model appropriate for Chichester or Worthing may not automatically translate to Crawley.

Community pharmacy forms a substantial part of the primary care network

West Sussex also has a large community pharmacy sector.

The final 2025 Pharmaceutical Needs Assessment recorded 142 community pharmacies, alongside 12 dispensing GP practices, five appliance contractors and two distance-selling pharmacies.

The number of physical community pharmacies had fallen from the previous assessment.

At the same time, pharmacies are increasingly being used to deliver clinical activity rather than functioning primarily as dispensing locations.

National and local Pharmacy First pathways already enable pharmacists to manage a range of common conditions without requiring patients to see a GP first.

In September 2026, NHS Surrey and Sussex announced a further local expansion through participating pharmacies, enabling pharmacist prescribers to assess and treat additional conditions including migraine, acne, scabies, some ear infections and other common presentations.

This is highly relevant to the future market.

Community pharmacy is increasingly being used as clinical primary care capacity.

Pharmacy access illustrates West Sussex's geographical challenge

The pharmacy network also demonstrates the difference between physical provision and practical accessibility.

The 2025 PNA found that all residents were within approximately 20 minutes of a pharmacy by car, including access to nearby provision outside West Sussex where appropriate.

But public transport did not provide the same level of accessibility in many areas, particularly rural communities.

Some residents in northern parts of Chichester district, for example, can be geographically closer to pharmacies in Hampshire or Surrey than to provision within West Sussex itself.

The PNA also noted that 86% of pharmacies opened during the day on Saturdays, while Sunday and late-evening availability was substantially more limited.

This illustrates a broader primary care principle.

A service can technically exist within a reasonable distance and still present accessibility barriers depending on:

• transport
• opening hours
• mobility
• digital exclusion
• work commitments.

The primary care opportunity can therefore concern access to existing capacity, not simply adding new premises.

Dentistry remains a different kind of access problem

NHS dentistry forms another significant part of the primary care market.

Across Sussex, NHS commissioners have continued to identify access as an area requiring improvement.

In 2025/26, NHS Sussex was using additional commissioning, contract changes and urgent dental capacity to increase activity. Commissioning work included additional capacity in areas including Arun, Worthing, Bognor Regis and Littlehampton.

In January 2026, another 26,546 urgent NHS dental appointments were announced across Sussex as part of the national expansion of urgent dental access.

The current NHS Surrey and Sussex system also maintains a dedicated urgent dental pathway for patients unable to obtain urgent care through their regular dentist.

For a prospective dental provider, however, unmet access need should not be confused with an automatically accessible market.

NHS dental activity depends heavily on NHS contracting and Units of Dental Activity, while the private dental market operates under very different commercial conditions.

A business case should therefore distinguish between:

unmet health need → unmet NHS-funded demand → commercially accessible private demand.

They are not identical.

Mental health increasingly intersects with primary care

Primary care also carries substantial mental health demand.

West Sussex's public mental health assessment estimated that around 17% of adults could be living with a common mental health disorder, although the underlying prevalence assumptions are derived partly from national survey evidence and should therefore be interpreted cautiously.

Mental health is increasingly embedded within multidisciplinary primary care models rather than treated solely as a secondary-care issue.

One current example is ADHD Primary Care Connect.

The neighbourhood-based pilot operates in Crawley alongside Brighton & Hove and Hastings and aims to bring assessment and ongoing support closer to local GP teams.

By August 2026, the service had received 2,440 referrals across the three pilot areas.

The significance is wider than ADHD.

It demonstrates how specialist activity can increasingly move toward primary and neighbourhood settings when the pathway can be redesigned safely.

That potentially creates new opportunities for specialist providers capable of working within integrated healthcare models.

Primary care is increasingly about managing the whole pathway

The common thread across general practice, pharmacy, dentistry, mental health and neighbourhood services is that the system is becoming more interconnected.

West Sussex faces genuine growth in healthcare need.

But the NHS response is not simply to create an equivalent percentage increase in GP appointments.

Instead, the direction is toward:

• prevention
• multidisciplinary working
• community pharmacy
• digital access
• proactive population health
• neighbourhood teams
• greater community-based care
• better clinical navigation.

• The weaker question

  • Can we provide healthcare?

• The stronger question

  • What existing pressure does this service relieve?
  • Where does the patient come from?
  • Where do they go next?

That is a much stronger way of thinking about the contemporary primary care market.

What does the West Sussex evidence suggest?

West Sussex has substantial and growing underlying demand for primary care.

The county's population is increasing and older than the national average. Long-term condition complexity is expected to rise substantially, while individual communities experience markedly different health needs.

But it is also an established primary care system.

There are dozens of GP practices, 21 Primary Care Networks, more than 140 community pharmacies and an increasingly broad multidisciplinary workforce.

The strongest signals therefore concern how capacity is used and where specific access or capability gaps remain, rather than a general shortage of primary care providers.

Areas particularly relevant to future development include:

1. Prevention and early intervention

   Population health programmes that identify risk before disease progresses.

2. Multimorbidity management

   Coordinated care for people with several long-term conditions.

3. Multidisciplinary primary care

   Roles that extend capacity beyond GP consultations alone.

4. Mental health and neurodevelopment

   Pathways such as ADHD Primary Care Connect moving specialist work closer to GPs.

5. Health inequalities

   Targeted work in coastal and deprived communities.

6. Pharmacy-led clinical care

   Expanded Pharmacy First and prescriber-led treatment for common conditions.

The geography of West Sussex is also important.

The needs of older coastal communities differ from Crawley's younger population and from rural parts of Chichester or Horsham.

A service that works in one locality may not address the same need elsewhere.

Starting a primary care service in West Sussex

For anyone considering starting or expanding a healthcare service in West Sussex, demand analysis should come before registration or significant investment.

A prospective provider should understand:

CQC registration is determined by the regulated activities actually being provided rather than simply by the business description.

Healthcare providers may require registration for activities including Treatment of disease, disorder or injury, Diagnostic and screening procedures and, depending on the service, other regulated activities.

Registration itself does not create patients or NHS contracts.

A credible primary care proposition therefore needs both a regulatory model and a clear route into the local healthcare market.

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

The direction of primary care in West Sussex

West Sussex's primary care market is likely to continue growing.

But the composition of that growth matters.

Population ageing will increase chronic disease and complexity. Population growth will add activity. Health inequalities will require more targeted interventions.

At the same time, the NHS intends to move more care away from hospital settings, intervene earlier and organise services around neighbourhood populations.

The creation of NHS Surrey and Sussex in April 2026 has changed the organisation responsible for commissioning, but its current strategy reinforces rather than reverses that direction: prevention, community care, neighbourhood integration and digital access are central to the next phase of healthcare development.

For prospective providers, the most compelling opportunities are therefore unlikely to come simply from observing that GP practices are busy.

They are more likely to come from identifying a defined clinical need that existing pathways struggle to meet and building a service capable of integrating with the increasingly multidisciplinary local system.