As the programme for Best Practice Birmingham 2026 continues to develop, a number of clear themes are beginning to emerge across both the clinical and operational agenda. Many of the themes shaping this year’s programme reflect pressures practices are navigating day to day, from referral pushback and workforce redesign, to AI governance, neighbourhood delivery and rising clinical complexity.  

The focus is increasingly shifting away from broad agreement around policy direction and towards a more practical question: how do practices deliver change safely and sustainably? 

One of the clearest examples is the growing pressure around referrals and Advice & Guidance. What was originally intended to support collaboration between primary and secondary care is, in some settings, becoming a source of uncertainty around responsibility, workload and risk. Practices are increasingly navigating situations where referrals are redirected, additional information is requested, or work returns to primary care without corresponding increases in capacity. 

This is not simply an operational issue. It affects clinical confidence, workload prioritisation and patient expectation management. As more demand shifts into primary care, questions around accountability and decision-making are becoming harder to avoid. These realities are increasingly shaping discussions around referral redesign, Advice & Guidance pathways and the growing operational pressure created when more responsibility shifts into primary care. 

Another strong thread emerging across this year’s programme is the growing focus on digital care and AI implementation. As AI tools begin to enter everyday practice, many teams are trying to understand how governance, oversight and clinical responsibility should work safely within existing workflows. 

This is particularly relevant in areas such as triage, diagnostics and workflow management, where expectations around efficiency are growing alongside questions around accountability and measurable impact. Increasingly, the focus is shifting towards practical implementation and operational governance, rather than future-focused hype. 

That same operational realism is increasingly shaping conversations around neighbourhood delivery. Across the NHS, integrated working remains a central ambition, but many practices are now asking how neighbourhood delivery can work effectively within the realities of day-to-day primary care.  

Increasingly, practices are looking for a clearer understanding of what is working operationally whether through access, continuity, workforce sustainability or reducing pressure across the system. The focus is increasingly shifting towards measurable delivery, implementation-led discussion and honest reflection around the practical realities of neighbourhood care.  

Alongside these operational pressures, clinical complexity continues to grow. Women’s health pathways are evolving rapidly, ADHD demand remains high, and the prevention agenda is becoming more operationally significant within everyday practice. These issues are actively shaping workforce and sustainability conversations. 

Whether it is applying the new endometrial cancer pathway in primary care, managing rising demand around ADHD shared care agreements, or recognising under-diagnosed presentations such as perinatal OCD, practices are increasingly balancing clinical complexity alongside operational pressure. There is also growing interest in how earlier intervention, symptom recognition and long-term management influence both workload and patient outcomes over time. 

What connects these discussions is not simply demand, but the challenge of implementing change safely, consistently and sustainably within already stretched systems.  

That is increasingly where the focus of conversation in primary care is shifting: towards how these changes are delivered. 

Across this year’s programme, there is a growing focus on how teams are delivering change within the pressures and constraints of everyday primary care. In many ways, the conversations shaping Best Practice Birmingham 2026 are the same conversations increasingly shaping general practice itself - how teams adapt safely under pressure, how delivery models evolve, and what sustainable care looks like over the coming years. 

Further programme announcements for Best Practice Birmingham 2026 will continue over the coming months, reflecting the operational, clinical and workforce realities increasingly shaping primary care delivery.