Every GP practice in England will now have to offer online appointment bookings, in a bid to reduce the so-called “8am scramble” every morning.
From 1 October, practices will be required to keep their online consultation tool open for the duration of their working hours for non-urgent appointment requests, medication queries and admin requests.
The change was announced in February as part of the new GP contract for 2025-2026, with the Department of Health and Social Care (DHSC) and NHS England stating the move would be “subject to necessary safeguards in place to avoid urgent clinical requests being erroneously submitted online”.
The British Medical Association (BMA) has opposed the plans and warned that serious health issues could potentially be missed.
It argued these promised safeguards have not been put in place and no additional staff have been brought in to manage what it predicts to be a “barrage of online requests”.
There are fears the change could lead to “hospital-style waiting lists in general practice” and “reduce face-to-face GP appointments”, according to the union.
It said this could risk patient safety as staff try to find the most urgent cases, with fears that reviewing online requests will take up too much time.
The BMA said on Monday that it would consider industrial action.
Many surgeries already have a system that allows patients to request consultations online, with staff reviewing these and booking appointments accordingly.
However, according to the DHSC, there is a lack of consistency, with some surgeries choosing to switch the function off in busier periods.
Care minister Stephen Kinnock said: “We promised to tackle the 8am scramble and make it easier for patients to access their GP practice – and that’s exactly what we’re delivering.
“We are bringing our analogue health service into the digital era, giving patients greater choice and convenience. We’ve learned from GPs who are already offering this service and reaping the rewards.”
It follows the announcement of an NHS online hospital unveiled by Sir Keir Starmer’s government at the Labour Party conference on Monday, which will see patients access medical care from the “comfort of their own home or their desk”.
Health secretary Wes Streeting said people will be able to use a “virtual hospital” from 2027 to speak to specialists, while those who prefer face-to-face appointments will still be able to have them.
Sir Keir Starmer also mentioned the online shift in his speech at the Labour Party conference, saying NHS Online will deliver “millions of appointments” digitally.
Announcing the new service, the prime minister said the government would “never” take away a face-to-face consultation “for those who want it”.
He said: “Think about a single mum juggling kids, trying to find time to speak to a specialist, or someone in their later years, living in a rural community miles from a hospital, who needs a check-up for a suspected eye condition.
“Why not have a doctor see you at home in your living room on an iPad, talking to you? No queues, no three-hour bus trip, no cancellation letters arriving after the appointment date.”
The government estimates the move to a virtual hospital will generate an extra 8.5 million appointments over three years.
BMA GP committee chair Dr Katie Bramall said: “At the start of this year, the government promised GPs across the country that they would implement the necessary safeguards that would enable practices to operate safely and prevent patient harm with online consultations and other IT changes. Unfortunately, this has not happened.
“Despite repeated warnings of the potentially significant risks, the government has refused to listen and act over GP concerns for patient safety. General practice online systems now risk being inundated with both non-urgent and urgent patient queries, leaving practices – regardless of size and the volume of queries they handle – to manage the fallout.
“We can only hope that no life-threatening issues are missed or delayed, but it’s a very real and present danger when we are handling over a million appointments each day nationwide.”
She added that GPs are “terrified” they are forbidden to divert patients to phones if they are inundated with online requests, and stressed their concerns were about “patient safety”.
“For the secretary of state to say it is ‘absurd’ that requesting a GP appointment is harder than ‘booking a haircut’ displays a deep misunderstanding of how general practice works and how understaffed and under-resourced it continues to be 14 months into their term of power.”
