NHS England urges GPs to ignore ‘irresponsible’ LMC advice on online access
Exclusive NHS England has written to all GPs urging them to ignore ‘irresponsible’ advice on contractual online access requirements shared by one LMC.
The letter, signed by primary care national director Dr Amanda Doyle and medical director Dr Claire Fuller, said that North East and North Cumbria LMC’s advice should not be followed as it encouraged GPs to act in ways that might be in ‘breach of their contracts’; could cause ‘distress or confusion’ for patients and; was ‘disrespectful to other professional groups’.
Last week, the LMC was threatened by its local ICB with ‘breach of GMC guidance’ messaging over the advice.
The ICB said that the advice, which the LMC told Pulse was ‘not approved in the format sent out’, implied that patients should deliberately use emergency departments for urgent care to ‘overwhelm departments to make a point’; and was ‘professionally inappropriate’ and ‘frankly dangerous to patients’.
NHS England urged GPs to disregard the advice, to ‘uphold’ the professional standards of general practice and ‘put patients first’.
The letter, seen by Pulse, said: ‘You may be aware of some communication from a LMC in relation to the online consultation contractual requirement, advising GPs to act in ways which might be in breach of their contracts, cause distress or confusion for patients and are disrespectful to other professional groups.
‘We are GPs ourselves. Every decision we take is in the interests of patients and to support the profession to do its best. That is why we know you will agree that GPs should not follow such irresponsible advice, especially where it may compromise patient care.
‘We know that every GP reading this letter will want to continue to uphold the professional standards of general practice and put patients first. Where there are difficulties in transition to new ways of working, we should work together.’
It also acknowledged that some practices ‘will still be having teething issues’ while implementing the requirements, but argued that practices who have made the change to their operating model ‘find they are better able to manage demand’.
The letter highlighted that in 2024/25, when making online consultations available throughout core hours was financially incentivised through the PCN DES, 85% of PCNs had confirmed to NHSE that all of their practices had achieved this, and ‘no patient safety events were flagged as a result’.
It added: ‘We are confident therefore, given this high baseline, that most of you will be delivering this for patients.
‘We are keen to support any practices who are finding it difficult to make this change. We would encourage anyone who is struggling to contact your commissioner and seek support.
‘NHS England and ICBs are fully committed to supporting practices to meet the contractual requirement.’
Since 1 October, GPs have been contractually required to keep online systems open for patient requests between 8am and 6.30pm for routine enquiries regardless of capacity, and ICBs have been told by NHS England that they should ensure the changes are implemented.
Yesterday the health secretary also condemned the LMC advice, saying that he was ‘shocked and appalled’ by it, as he accused the BMA of fostering an environment of ‘extremism’ among LMCs.
The BMA said it stood by its initial comments that had ‘no role in its drafting or dissemination’, and its content does not represent the position of the BMA or GPC England.
The BMA is currently in dispute with the Government over the changes, with its position being that the requirements are currently unsafe.
Pulse exclusively revealed that practices in one area have already received contract breach messages from their ICB, two days after the requirement came into effect.
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READERS' COMMENTS [8]
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Didn’t think Amanda Doyle was still a GP
Obviously she has become an ex-GP, having been converted to something else instead.
Pot and kettle? more like pot and tea-cup !
Better funded practices also have better access; demographic and geographic variations matter. Amazingly rapid in leaders’ uniting their condemnation, but predictably absent “support” when it comes to “working with” GPs, who are rightly sounding an alarm at the failure to deal with the basic and persistent fact of inadequate GP cover to safely triage record numbers of patients. GPs have been firefighting for far too long and our leaders have condoned this as normal, with the complicit detachment that online solves the problem and that GPs are just being lazy or awkward.
Dangerous extremism is when you refuse to engage with the current overwhelm that faces patients, despite having the knowledge and agency to act on the solution.
What exactly are you required to do for on line access . I work in Scotland and the practice where I Locum have a system where you can email in and someone will phone you back same day . If required you will then be put in a queue to speak to a GP and if necessary given a face to face appointment. This is to get round the problem of patients having difficulty getting through on phones . Would that be acceptable as online access .
Couldn’t agree more! Being “committed to support” – is not the same as actually making resources available. Hollow words each time something changes, then accuse practices of letting patients down. I’m a few years from retirement and so may sound a bit luddite – but remember when the GP contract was introduced and we were told that the terms and conditions would not be altered “except in times of national emergency” – and now here we are pushed to limits never dreamed of in those days.
I’m loving the “disrespectful to other groups” comment. If the NHS had any respect for GPs at all this wouldn’t have got to this point. Look what happens when a tiny bit comes back the other way. They really don’t see the point at all.
NHS England urges GPs to ignore ‘irresponsible’ LMC advice on online access – DIVIDE AND RULE 🙂
The NHS 10 year plan for failure, the Fuller fantasy , the further abuse of NHS taxpayer funding with further unnecessary walk in centres knowing previous Darzi centres wasted millions, and a group of clueless perennially failing detached hopelessly incompetent NHS England & ICB leaders led by a clearly inadequately experienced health secretary with no meaningful NHS background will result in an ongoing failing NHS and Primary Care . Hiding behind the now old chestnut of the digital and AI smokescreens with a dangerous online access policy intended specifically to mislead the public and to enable government /NHSE continued use of misrepresented access figures will not cover up their lamentable ongoing NHS management bungling.