GP practices in England are spending the time equivalent of almost 210,000 appointments a week handling reforms to online access put in place from October.
A survey of 412 practices carried out by Management in Practice and our sister title Pulse has also revealed that just under half – 43% – have extended staff hours to cope with the contractual changes and the extra workload created as a direct result.
From 1 October, surgeries have been required 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.
Our survey results show that 93% of practices are now implementing online access throughout core hours, up from 60% pre-1 October.
But it comes at a cost in terms of staff time, patient appointments, as well as adding to pressure on budgets as staff hours are increased or new hires are brought in to help manage demand.
For example, findings based on responses from a mix of practice managers and GPs, showed that:
- The average GP is spending 53 minutes a week implementing the changes.
- Non-clinical members of staff are each spending 42 minutes a week managing online access and for admin members of staff, it’s 31 minutes.
- Projected out to the entire full time equivalent GP workforce in England, this equates to over 34,000 hours each week, or 209,442 appointment slots that are 10 minutes long.
- One in six practices (16%) have had to hire additional non-clinical staff.
- Almost half (47%) of practices have seen routine waiting times increase as a result of the reforms.
The BMA has formally entered a dispute with the Government over the recent online tool changes, warning that many practices would struggle to implement them safely and would have to introduce waiting lists.
One practice manager based in Dorset commented that the practice had ‘seen a 15% increase in online requests since 1 Oct’, adding that although they were hiring additional staff to manage, ‘having to find additional resource to manage this demand [is] not easy’.
Another said it has caused a 25% rise in workload, with the result extra staff, including locums, have had to be drafted in. Yet another described the work as a ‘never ending surge of requests’ piling pressure on GP teams.
A practice based in the north of England said the biggest impact of the changes has been on routine appointments and continuity of care, as it is ‘harder for patients to see the GP they would prefer when they want to’.
However, several practice managers noted existing staff – either mainly GPs or managers – have no choice but to absorb the extra workload because expanding capacity is unaffordable.
A GP in Cambridgeshire said the changes have made their practice ‘feel even more like a production line’. They said: ‘The GP day, which was previously already “full on” – grabbing lunch, difficult to find time even to eat, debrief registrars or go to the toilet – has now become even more relentless.
‘How sad to feel even more like a production line. Quality general practice needs time to pause, evaluate, reflect, contact patients about abnormal results, check in on cancer or palliative patients.
‘With all inputs on, all of the time in the day, the quality of care in other areas will reduce as we can’t fight fires and plan holistic medical care for vulnerable patients simultaneously.’
And a Merseyside GP said both partners at their surgery are now working very long hours to prevent next-day backlogs building up. They said: ‘I stay in the surgery until I can’t think any more, some days that’s been 10 or 11pm’.
Meanwhile results also showed that two fifths (40%) of practices are clearing online requests made late (between 5.30pm and 6.30pm) if they have time, but otherwise deferring. A similar percentage (36%) are clearing requests that day.
Common measures for dealing with the changes reported by respondents include blocking appointments to create space for triaging (58%) and extending staff hours (43%) – see below.
A spokesperson from the Department of Health and Social Care said: ‘This data only represents a very small percentage of GP practices. Patients want this service, with more people now contacting their GP online than by phone, and we gave practices six month notice to prepare for the rollout.
They added: ‘We are grateful to the majority of practices are already delivering this service successfully – to the benefit of patients and their care – and we are supporting others to increase compliance’.
Last week, our survey revealed that that the new requirements around online requests are risking patient safety as urgent clinical problems are being flagged via online forms.
Our survey was open between 18 and 24 October 2025, collating responses using the SurveyMonkey tool. The survey was advertised to readers of Pulse and Management in Practice via our website and email newsletter, with a prize draw for a £250 voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the GP and practice manager population.
