Anshumen Bhagat, NHS GP principal and chief medical officer at private healthcare provider GPDQ, argues that mental health is central to successful health systems.
The primary care workforce crisis is usually framed as a numbers problem. Too few GPs and nurses are cited as the root cause of not enough capacity to meet demand. But while these pressures are real, they mask a deeper and more uncomfortable truth: the system is losing clinicians not because they don’t want to care, but because the way we ask them to care has become psychologically unsustainable.
As a practising NHS GP, I see this daily. Primary care clinicians are carrying limitless patient demand within appointment structures that are no longer fit for purpose. Ten-minute consultations are expected to absorb increasingly complex clinical presentations, safeguarding concerns, administrative burdens and emotional labour – all within fragmented systems that rarely speak to one another. The expectation is not just clinical competence, but infinite resilience.
This erosion of well-being is no longer anecdotal. The 2024 NHS Staff Survey revealed that 41% of staff reported being unwell due to work-related stress in the past year. That figure should concern us not only as clinicians but as leaders and system designers. Burnout is not a personal failure; it is a predictable outcome of poorly designed operating models.
Mental health is infrastructure, not a soft issue
In healthcare, we are comfortable talking about infrastructure in terms of estates, digital systems or workforce numbers. We are far less comfortable recognising that clinician mental health is core infrastructure too. When clinicians feel they can never finish their day because work is endlessly unfinished and emotionally unresolved, the system accumulates hidden risk. This often surfaces as reduced decision quality, presenteeism, attrition and ultimately, compromised patient care.
From a business and governance perspective, this is not just a well-being issue. It is an operational and financial one. High turnover, sickness absence and reliance on short-term fixes cost organisations far more than investing in sustainable workforce design upfront.
If we want resilient healthcare systems, whether public, private or hybrid, we need models that align three fundamentals. These are clinical autonomy, strong governance – with consistent standards, clear accountability and patient safety at scale – and flexible work design with careers that are sustainable over decades, not just tolerable for a few years.
There are solutions out there. Independent platforms that provide and support nationwide healthcare services are often built around these principles from the start. The goal is not to pull clinicians away from the NHS, but to support them across portfolio careers that span NHS, private and hybrid settings. Variety of work as well as peer support and psychological safety are not indulgences – they are protective factors against burnout for healthcare professionals across the breadth of primary care.
Crucially, this approach does not mean lowering standards. In fact, strong clinical governance becomes even more important. Clinician-led decision-making and robust quality oversight are what allow flexibility and scale to coexist. When clinicians are trusted and supported to work within well-governed systems, both quality and satisfaction improve.
Private and hybrid models as innovation testbeds
The reality is that the NHS, by its nature, is risk-averse and structurally constrained. That makes large-scale experimentation difficult. Private and hybrid models can act as testbeds for innovation to pilot new workforce structures, governance frameworks and uses of technology that prioritise both quality and clinician wellbeing. They allow faster iteration and the ability to design services around both patient outcomes and clinician experience.
The opportunity is not to pit sectors against one another, but to learn across them. What works in a well-governed private setting can inform NHS reform; what defines excellence in NHS care should set the benchmark everywhere else.
The workforce crisis will not be solved by recruiting more clinicians into systems that exhaust them. It will be solved by designing environments where clinicians can do their best work and feel professionally fulfilled, increasing the likelihood that they remain in practice for the long term. Portfolio careers, flexible models and psychologically safe working environments should be seen as sustainability tools, not exits from the system.
Mental health and well-being are not side conversations. They are signals telling us whether our systems are fit for the future. If we listen and design accordingly, primary care can move from survival mode to sustainability.
