Reimagining general practice for the NHS 10-year plan: organisational culture as the social determinant of team health

General Practice in the UK faces acute pressure from rising demand, workforce shortages, and policy changes. Traditional NHS reforms, focused on financial incentives and activity targets, often overlook the human-centred complexity of primary care. This commentary presents a five-year cultural transformation at Birley Health Centre in northern England, centred on the ‘social determinants of team health’.

Drawing on organisational psychology, leadership theory, and staff experience, we outline practical strategies to build psychological safety, communication, autonomy, and inclusive leadership. Key changes included redefining non-clinical roles, improving recruitment, fostering everyday trust, and embedding leadership based on empowerment and humility. These shifts led to lasting gains in staff morale, patient satisfaction, and care quality.

We argue that, in this organisational setting, a deliberately nurtured culture of psychological safety and relational trust became a core driver of systemic improvement, particularly vital in the post-pandemic context of recovery and workforce fatigue. Birley’s experience offers a replicable model for GP practices and policymakers seeking to revitalise primary care. As the NHS implements its 10-Year Plan, we advocate for prioritising leadership development, healthy team dynamics, and patient engagement as essential to sustainable reform.