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.
The commissioner has also asked ICBs to ‘identify’ any GP practices who ‘may be struggling’ to implement online access changes which came into effect yesterday.
New FAQ guidance has been published by NHS England on the contractual changes, which require practices to keep their online consultation tool open during core hours (between 8am and 6.30pm) as a minimum for non-urgent appointment requests, medication queries and admin requests.
It has stated that 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’.
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.’
The recent GP contract changes have led the BMA to formally re-enter a dispute with the Government. Its GP Committee said it signed up to the policy only on the condition that ‘appropriate safeguards’ would be put in place, so that urgent requests cannot be sent online and potentially missed.
In an exclusive interview with our sister title 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 said: ‘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.
‘I think it’s tone deaf, to be honest with you.’
By October 1, practices were also required to have posted the patient charter ‘You and Your general practice’ on their website.
The charter includes rules for GP practices and guidance for patients on access and registration.
A version of this article was first published by our sister title Pulse
