NHSE sets out when GP practices can switch off online consultation tools
GP practices are only allowed to switch off online consultation tools in core hours in ‘exceptional circumstances’ and with ICB approval, NHS England has said.
NHSE also asked ICBs to ‘identify’ any GP practices who ‘may be struggling’ to implement online access changes which came into effect yesterday.
In new FAQ guidance on the contractual changes, the commissioner said practices can only switch off online consultation tools during core hours ‘in exceptional circumstances’ and that this would need to be communicated to and agreed with their ICB.
It added that it does not support limiting clinical contacts to ‘a specific number’ and that it will not provide a definition of ‘urgent’ request, as ‘assessing a patient as urgent should be based on clinical judgement’.
GPs are now contractually required to keep online systems open for patient requests between 8am and 6.30pm for routine enquiries and the BMA has formally re-entered dispute with the Government over the changes.
NHS England also clarified that the contractual requirement remains that patients should ‘know on the day’ how their issue will be handled, regardless of when their request was sent to the practice within core hours.
The FAQ document said: ‘We are asking ICBs to continue working with general practice and identify any practices who may be struggling to implement online consultation. ICBs are asked to support these practices to go live and use the support available.
‘NHS England does not support limiting clinical contacts to a specific number but encourages practices to improve their operational processes and capacity so that demand can be effectively managed.
‘Commissioners will follow up with practices that do not have online consultation on throughout core hours to support adoption throughout core hours.’
NHS England reiterated that it is up to practices to implement the safeguards, which consist of signalling to patients that urgent requests cannot be made via the online tool.
It said: ‘Practices are able to review the standard wording provided by their online consultation system supplier to ensure it accurately describes the service.
‘The information should clearly state the tool is not appropriate for urgent medical needs, explain how patients can access support for urgent situations, set clear expectations about the service, and describe how consultations will be processed.’
Pulse has heard concerns from GPs that if there was an influx of online patient requests at the end of core hours, at 6.20pm for example, they would had to respond to all of those queries in the same day.
In an exclusive interview with Pulse, BMA GP committee chair Dr Katie Bramall said that it appeared that the FAQ document was ‘doubling down’ on the requirement for practices to provide a response on the same day, even if requests are sent shortly before 6.30pm.
She told Pulse: ‘It’s like the FAQs are doubling down. They’re saying on the one hand, they want to be supportive of practices, but on the other they’re saying: ‘You’ve had plenty of time, we’ve talked about this for years. It was announced in May 2023.’ Which, of course, was a year where the contract was imposed. The same goes in 2024 when they snuck in core hours changes.
‘I think it’s tone deaf, to be honest with you.’
She also said she had conversations with ‘senior government advisors’ at the Labour Party Conference earlier this week around the changes, where they indicated they were not out to get practices over the contractual change.
She told Pulse: ‘They said: “We have no interest in breach noticing any practice.” And I said: “Well, then you need to put that in black and white, so that then practices understand that they’ll do the very best they can, but you’re not going to start weaponising this.”
‘But they’ve refused to. I still have every hope that they will do so, because that would be in everyone’s best interest, but they seem intransigent to that, and I think that’s deeply regrettable and very irresponsible.’
The BMA has reminded practices that despite the dispute, GPs must still comply with the contractual obligations, although they will be working ‘under protest’.
It comes as the primary care minister told Pulse that the Government will not be ‘unpicking or unravelling’ the changes, which ‘both parties signed up to’.
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READERS' COMMENTS [8]
Please note, only GPs are permitted to add comments to articles
There is a limit to the number of patients that can be seen within core opening hours. Any idiot can realise that
if I’m full and there’s an urgent problem, then they’ll be going to the walk-in centre.
If you’re getting scores of online requests for advice coming through and you haven’t got the capacity to do anything other than to put a holding message out, then that’s what they’ll get. End of.
The Government appears to undervalue the vital role of doctors when comparing healthcare professionals to services such as food delivery, hairdressing, or taxi bookings. Unlike those professions, doctors undergo at least five years of rigorous medical training, followed by specialist training, annual appraisals, continuous professional development, and constant adaptation to NHS England’s ever-changing demands.
Despite this, doctors face increasing pressure, scrutiny, and diminishing autonomy. Politicians—who often enter power without formal training, accountability, or the same professional standards—make sweeping changes to healthcare that serve political interests rather than public need. From the previous government to the current administration, policies such as “open access” to GPs may sound appealing but will not improve patient care or safety.
Public trust in NHS England is already eroding, as is the morale of healthcare professionals. These reforms will not affect the political and financial elite, who can afford private care, but they will worsen inequalities for ordinary people who rely on the NHS.
It is essential that the Government acknowledges the depth of medical expertise, restores trust, and engages meaningfully with frontline clinicians before introducing reforms that risk damaging patient care further.
Why is the govt throwing flames on the fire? Is it really in anyone’s interest to try and devalue the profession. How can they really compare General Medical practice to Ubereats or booking a haircut.
When the public are constantly told they can’t get an appointment, even they parrot the nonsense line. I’ve heard patient’s say it to clinicians when they’re sat in front of one, an appointment they requested less than 3 hours prior! But if you hear everyone else say it and the filthy Murdoch rags AND the government… it’s a bit of an echo chamber.
Is the agenda really to try and break the doctor’s backs?
If the marginal cost to the consumer is only their opportunity time cost to attend the appointment, and the time cost trying to get an appointment, and you reduce the later to nearly zero – demand, already unmet, will increase given supply is fixed in capitated funding system.
We were trying to be innovative and thinking of starting to offer a hairdressing and takeaway service (for free of course) but realised that people perhaps didn’t want bits of hair in their kebabs even though it was super convenient 😩
The government seems to perpetually confuse
‘Access’ with ‘capacity’.
NHS England has an unblemished record of failure across all areas of healthcare, yet they set the guidance!
If they ask simple medical question then redirect to NhS websites.
Triage some people to no call required
Generate a Streeting Waiting List which can be years long for non serious problems.
If colds then wait and if no second call in 5
Days cancel.