Under pressure: an analysis of primary care pressures facing ICSs at launch, funded by health management consultancy Acumentice, is set in the context of the creation of the new integrated care systems (ICSs). 

Among the insights: 

• The number of primary care appointments per head of population is 58 per cent greater in Cornwall ICS than in North Central London
• There’s an almost threefold variation in the number of patients who attend A&E after failing to get a GP appointment – from 16 per cent in Black Country ICS to 6 per cent in Herefordshire and Worcestershire
• Herefordshire and Worcestershire also has the lowest GP to patient ratio, at below 1,500; Kent and Medway is 50 per cent higher at more than 2,000
• The two West Midlands ICSs both have 20 per cent of patients noting a fairly or very poor experience of primary care, more than double the 6 per cent of Gloucestershire ICS. 

The report also combines metrics, including measures of deprivation, to assess ICSs on the level of pressure and challenge across primary and secondary care. It suggests that for new ICS leaders, “understanding these differences in population health need, through detailed and co-ordinated data analysis and working closely with local places to develop tailored approaches will be critical”.

The same could be said of local pharmacy leaders looking to identify opportunities for the sector to offer tailored services designed to relieve the pressures specific to each area. For example, the report maps the data readily available for GP appointments, to explore demand, access and patient experience (Figure 1, above). When it comes to assessing relative primary care pressures, seven variables are used to produce a ranking (Table 1). 

The authors have also cross tabulated a ranking of deprivation (Table 2) against primary care pressures to produce a list of systems where higher levels of deprivation also face higher relative primary care pressures: Cumbria and North East, Derbyshire, Kent and Medway, Lincolnshire, Norfolk, North East London, Nottingham, South East London, South Yorkshire and Bassetlaw, The Black Country and West Yorkshire.

These kind of data could, for example, be used to identify areas where patients in deprived areas are voting with their feet because they are unable to get a timely GP appointment, and where drilling down into more local data could reveal options for more bespoke services.