Recent changes in GP appointment booking policies, driven by Government mandates, have generated significant challenges for general practice in England, with doctors reporting a substantial loss of available consultation time and growing patient wait times. The updated NHS contract, which came into effect recently, requires surgeries to offer online appointment requests from 8am to 6.30pm, aiming to replace the traditional 8am telephone rush with improved accessibility. However, this policy shift has produced unintended consequences, according to a survey of 431 GP practices published by trade magazines Pulse and Management in Practice.

The survey reveals that due to the influx of online appointment requests, GPs are effectively losing the equivalent of around 200,000 appointments weekly. Many practices have been forced to reduce the overall number of consultations to free up time for triaging these requests. On average, GPs spend 53 minutes a week managing online submissions, while clinical and administrative staff spend between 31 and 42 minutes. Extrapolated across the GP workforce, this translates to over 34,000 hours weekly, equivalent to more than 209,000 ten-minute appointments lost. Nearly half of the responding practices reported increases in patient waiting times since the change, and only about one-third can clear all late online requests on the day.

Medical professionals have expressed deep concerns that the systems do not discriminate between urgent and routine enquiries, resulting in potentially serious complaints—such as breathing difficulties, acute chest pain, or severe vomiting—being buried in the volume of online messages. The British Medical Association (BMA) has warned that this creates a risk of missing life-threatening conditions amid a ‘huge haystack of unmet patient need’. Several GPs described the new environment as relentless and resembling a production line, with one practitioner from Cambridgeshire lamenting the impact on the quality of holistic patient care, noting the strain on time for reflection, follow-up, and complex case management. Another GP from Merseyside reported working well into the night to prevent appointment backlogs.

To cope, many practices have adopted measures such as blocking appointment slots to dedicate time to triaging requests, extending staff hours, and hiring additional personnel. One Surrey GP practice, for example, had to turn off the online booking tool partway through the day to allow receptionists to make follow-up calls, yet still saw a 15% increase in online submissions since October.

Despite these grievances, the Government, led by Health Secretary Wes Streeting, has defended the policy, stating that it offers a modern and equitable way for patients to access care—comparable to booking other everyday services online. The Department of Health and Social Care noted that most practices have successfully implemented the system and that it is supported by an additional £1.1 billion in funding and the recruitment of 2,500 new GPs to bolster capacity. A spokesperson also emphasised that the survey data represents only a small proportion of GP practices.

The shift to online booking aligns with broader efforts to digitise NHS services, including the NHS App, which by mid-2022 had over 28 million registered users accessing features such as GP appointments, prescription ordering, and health records. NHS England has promoted online consultation systems to reduce face-to-face contacts and free up phone lines for urgent calls. Official guidance highlights benefits such as reducing ‘did not attend’ rates by allowing easier cancellation and rebooking, and enabling patients to view test results online to avoid unnecessary contacts. However, real-world experiences indicate a complex picture where increased demand and unmet patient needs challenge the intended advantages.

Complementary reports on patient access to GP services reveal mixed experiences: while many still rely on telephone bookings, a smaller but growing number use online systems. Surveys show that approximately 14% of patients remain unable to secure GP appointments, citing issues such as not getting appointments with preferred clinicians, being advised to visit accident and emergency departments instead, or finding all appointment slots full. On the positive side, some patients report proactive contact from surgeries and opportunities to address concerns during routine visits.

Adding to the pressures on GP services, recent technological disruptions further complicated access. In July 2024, a widely reported outage affected the NHS’s EMIS system—a platform used for GP bookings and patient records—due to an incident linked to the cybersecurity company Crowdstrike. Although emergency services remained operational and contingency plans were enacted, the disruption compounded existing challenges in appointment management. Health Secretary Streeting ordered an independent investigation and was engaged in talks to resolve junior doctors’ strikes, amplifying attention on NHS operational resilience.

In sum, while the Government’s push toward online booking systems for GP appointments reflects a drive to modernise and improve patient access, doctors and frontline staff report significant operational strains and longer waits for patients. The BMA’s ongoing dispute with the Government and threats of industrial action underscore the tension between policy ambitions and the realities of current NHS capacity. Moving forward, balancing digital innovation with adequate resourcing and safeguarding clinical quality will remain critical to maintaining accessible, timely, and effective primary care in England.

📌 Reference Map:

  • [1] (Daily Mail) – Paragraphs 1, 2, 3, 4, 5, 6, 7, 8
  • [2] (Reuters) – Paragraph 9, 10
  • [3] (NHS England brochure) – Paragraph 5, 6
  • [4] (Wikipedia NHS App) – Paragraph 6
  • [5] (NHS England publication) – Paragraph 6
  • [6] (Healthwatch Richmond) – Paragraph 7
  • [7] (Healthwatch West Northamptonshire) – Paragraph 7

Source: Noah Wire Services