The GP online access fallout: A timeline

Scarlett Clarke details the key dates in the contract row between the BMA GP Committee and the Government. This is a live document, and will be continually updated

Late 2024/early 2026: First contract negotiations were undertaken with Wes Streeting as health secretary. Mr Streeting was pushing for online consultations to be available for patients throughout routine hours, taking away the right for practices to switch it off when demand is too high.

24 February: Agreement was close to being struck between the BMA GP Committee England and NHS England for the 2025/26 contract. Pre-final agreement, an email was sent from DH/NHS England saying that these requirements would be implemented from 1 October, and it would be up to GP practices to ensure patient safety.  

28 February: The BMA publicly accepts 2025/26 contract for GPs in England. The Department of Health and Social Care and NHS England confirmed that ‘necessary safeguards’ would be in place before 1 October 2025 around online access.

9 April: DHSC sent the contract regulations to the BMA for approval, which detailed the wording in the contract.

The regulations clarified that online consultations would need to be switched on from 1 October, regardless of whether software companies were able to introduce safeguards.

25 April: The deadline for amendments to the contract regulations passed. The GPC negotiators did not suggest major amendments to the wording for online access.

07 May: The BMA released guidance on the new contractual requirement for all-day online consultations. Here they suggested the contract would result in only a ‘temporary’ spike in GP demand, rather than a ‘sustained increase’.

21 August: A contract variation notice was published stating that as well as keeping online consultation tools open, GP practices would also be expected to keep their premises and telephone open 8am-6:30pm from 1 October as well.

12 September: A liaising group of West Midlands LMCs wrote to Dr Bramall  to urge her to re-enter a contract dispute with the Government over the 1 October access changes. They also urged the GPCE to provide guidance to practices to actively breach their contract on access from October, as LMCs cannot.

14 September:  The BMA voted to support the GP contract dispute in a ‘special representative meeting’ (SRM), but not over the access regulations. Instead, support for the dispute was dependent on  ‘sufficient legislative safeguards’ being introduced to protect the GMS contract and partnership model.

17 September; Dr Bramall wrote to health minister Stephen Kinnock listing some of the safeguards that would need to be put in place around online access. These included:

• removing any free text box to prevent patients submitting ‘urgent clinical requests erroneously’
• allowing patients to only select specific non-urgent requests or queries via tick-boxes
• directing patients to call the practice if their request or query is urgent

29 September: The BMA gave the health secretary 48 hours to avoid a dispute with GPs.

1 October: Contractual changes were implemented and the BMA entered into a formal dispute with the government. 

Primary care minister Stephen Kinnock told Pulse that the Government would not renegotiate GP access changes, stating that ‘the commitment to online consultation is a cast iron commitment in the contract’.

30 October: A Pulse and Management in Practice survey was published, highlighting GPs concerns that new contract regulations are compromising patient safety.

7 November: The England LMCs conference was held. Dr Bramall launched a passionate speech against NHS England and ministers, which featured a ‘rogues’ gallery’ of ‘traitors’ to the profession, which included ministers. Dr Bramall said the GPC had been given assurances that the changes would not be rolled out without more safeguards in place.

A number of motions called on GPC to escalate the contract dispute, including potential full-day walkouts, undated resignations and refusing online access compliance were backed.

10 November: Mr Kinnock responded to the LMCs conference, asserting that the BMA was being ‘turned into a farce’. He said that the ‘escalation’ was ‘founded on untruths’ and would ‘put patient safety at risk’ at a critical time ahead of winter’.

14 November: DHSC and NHSE cancelled all meetings with BMA GP leaders, citing anger at Dr Bramall’s conference speech.

25 November: The Government announced plans to overhaul the negotiation process, where the BMA would now only be consulted among other stakeholders, diluting their role in discussions.

27 November: The BMA secretariat provided a verbal report to the GPC laying out problems with the process. This came with the information that the GPC executive initially raised no objections to the regulations; Dr Katie Bramall had signed off on them.

1 December: The Government approached the BMA to consult with them as part of the new process.

5 December: BMA GPCE leadership said no GP collective action is planned before next Spring (but implied there could be if contract imposition continued).