Increasing numbers of GPs are building organisations that are capable of preserving the personal, local nature of general practice while also offering patients and communities a greater range of services, a review has said.

The Nuffield Trust and The King’s Fund found that GPs were acting in response to the changing health needs of the general population.

But while some doctors are adapting to new models of primary care, others risk being left behind as they are caught on a treadmill of trying to meet the existing pressures from supply, demand and health service factors.

This is despite the fact that they are well aware of the need for change, highlighting a lack of time at their disposal to reflect on how to provide and organise care for the future.

The report, commissioned by the former NHS Midlands and East Strategic Health Authority, calls for a new national framework. It wants to see NHS England, GPs, clinical commissioning groups, professional bodies and patient groups all come together to shape the evolution of primary care.

“Radical change will depend on support, incentives, and GPs feeling that they have permission to test out new approaches to the delivery and organisation of care,” said Nuffield Trust director of policy and lead author Judith Smith.

“Policy-makers and commissioners will need to put in place imaginative measures that make the most of the strong history of independence and innovation within general practice.”

To alleviate the “significant strain” that general practice in England is currently under, the review proposes a set of design principles, spanning both clinical and organisational domains, to be used by commissioners, GPs and other primary care professionals when planning future provision.