Changes to GP booking rules – and why GPs are pushing back
The British Medical Association announced yesterday it has entered into a formal dispute with the Government over new contractual changes on GP patient access.
Wes Streeting, Secretary of State for Health and Social Care of the United Kingdom, says he won't back down on improvements for patients.
What changes have come in?
From 1 October 2025, GP surgeries (practices) must enable patients to seek appointments at all times throughout core hours of 8am to 6.30pm, Monday to Friday, They must use the method that best suits them - phone, in person, or via online requests. This was agreed between the Government and British Medical Association in April as part of negotiations for the GP contract 2025 to 2026.
How should this benefit patients?
As many of you have told Healthwatch, patients face variable experiences of online request functions (such as E-consult), with some practices turning this on and off during different times of the day or capping the numbers of people who can use this access route daily. This has inconvenienced patients who may face barriers to traditional means of contact, because of work, caring or other time sensitive commitments. Healthwatch have asked Government to improve GP access and last year it announced an extra 1.1 billion pounds for GP services.
Why is the British Medical Association unhappy about the changes?
GP leaders said they initially agreed to these changes 'on the condition' that ‘necessary safeguards’ would be put in place before 1 October 2025. They say online systems cannot currently distinguish between non-urgent and urgent patient queries and with practices already understaffed and overworked, 'GPs fear this could lead to potentially serious and life-threatening problems being delayed or missed entirely'.
How has the government reacted?
Health and Social Care Secretary Wes Streeting said in his Labour Party conference speech earlier this week: "Why shouldn’t booking a GP appointment be as easy as booking a delivery, a taxi or a takeaway?". Referring to the extra investment in general practice and the British Medical Association's opposition, he added: "If we give into the forces of conservatism, they will turn the NHS into a museum of 20th century healthcare. We will always stand up for the interests of patients and we won’t back down."
His department also officially announced the launch of the changes yesterday.
What does being 'in dispute' mean for patient care?
As independent contractors, GPs can't go on strike like doctors can if they are employed at hospitals. The British Medical Association says going into dispute 'is the first step in showing how GPs react to threats to patient safety'. While it hasn't publicly talked about or told the government that GPs will cut back their workload, it has had safe working guidance in place for a while which suggests actions such as capping the number of patients a sees a day to 25.
What would end the dispute?
The British Medical Association has requested urgent talks with NHS England by 1 November 2025, along with written reassurances that no practice would be risk a contractual breach notice should the practice 'be forced to divert urgent same-day patient contacts to telephone and walk-in due to overwhelm of patient need exceeding available clinical capacity'.
What is the Healthwatch view view?
Healthwatch North Yorkshire and across the rest of England are concerned that patients will be caught in the middle - hearing from the Government that they can access online services all day while hearing from GP practices that they just can't cope and make this available. This needs to be resolved quickly between both parties but ultimately Healthwatch back improvements to online access for patients. This is the comment we shared in a Government announcement yesterday.
Ashley Green, Chief Executive at Healthwatch North Yorkshire, said:
"Patients often tell us how frustrating they find the early-morning scramble for on-the-day GP appointments. Many people are stuck in long phone queues, only to be told all the appointment slots have gone. People also tell us that online booking systems can be unpredictable - switched on and off at different times during the day with little notice.
Giving people the ability to contact their GP using the booking method that most suits them, at any time during their surgery’s core hours, is a welcome shift. This move will help improve consistency, give patients greater choice, and mean they can fit appointment booking around work or caring responsibilities.
Thenews about flexibility when booking appointments at GP practices is a timely reminder that patients with accessibility needs – such as people with hearing, speech or mobility difficulties – must not be left behind, nor should those who don’t have access to digital devices or the skills to use them.
It’s now up to those who fund and organise NHS and GP practices to ensure this change is felt nationwide so patients no longer face a postcode lottery when booking a GP appointment."
