The state of health care and adult social care in England 2025/26

Key points

• More than 4 out of 5 (87%) GP practices assessed under our current assessment framework are rated as good. A further 3% are rated as outstanding. The remaining GP practices are rated as requires improvement (9%) or inadequate (1%).
• GP appointment rates have increased: in 2025/26, the number of appointments per 100,000 patients rose by 2.4% over the previous year, and have increased by 9.7% since 2022/23.
• Following the requirement for GP practices to keep online consultation tools open during core hours from October 2025, the volume of requests to GP practices using online consultation systems per 1,000 patients increased by 67% between March 2025 and March 2026.
• As online contacts have increased, patients who responded to the GP patient survey are finding it easier to contact their GP practice, with 73% of people describing their last experience of contacting their GP as ‘good’ compared with 70% in 2025 and 67% in 2024.
• There is considerable variation in the number of GP practice staff per 100,000 patients in different integrated care board (ICB) areas. This ranged from 38 GPs to 56, and from 13 nurses to 45. London has some of the lowest staffing rates, and the South West region some of the highest.
• Inspection reports for GP practices rated as requires improvement or inadequate showed persistent gaps in staffing, which could result in increased workload for existing staff, reduced ability to complete required training, and longer waits for appointments.
• Levels of NHS dental activity continued to recover in 2025/26, although remained below the level of treatment delivered in 2019/20. There is considerable regional variation in the number of dental practices per 100,000 people, with the highest numbers in London and the South East, and the lowest in mainly rural areas. We are concerned about the potential for this disparity to produce further inequalities in access to dentistry and oral health outcomes.
• A growing number of people are waiting for community health services, including care provided in people’s homes and community clinics, as well as health promotion services such as health visiting. Although the number of adults waiting over a year has reduced, the number of children and young people waiting over a year has increased by 129%, with the majority of these very long waits for community paediatric services.
• Primary and community care plays a vital role in reducing health inequalities. We have seen how some providers are committed to reducing these inequalities. However, there is a 27 percentage point difference in the proportion of adults living with severe mental illness who receive annual health checks by ICB area, autistic people and people with a learning disability continue to be less likely to describe their experience of their GP practice as good, and there is variation by age, ethnicity and across ICB areas in the proportion of people receiving effective treatment for lowering blood pressure.