One in three GP practices surveyed in England reported reducing face-to-face appointments after contractual changes required online consultation systems to remain open throughout core hours. GP leaders say the additional screening and triage workload is consuming clinical time, although NHS England reports that the total number of in-person appointments has increased.
Around 32% of GP practices responding to a survey by Pulse and Management in Practice said they had reduced face-to-face appointments following changes to online access requirements.
The survey also found that:
- 25% believed patient safety had been placed at risk.
- 60% reported that GP partners were working longer hours.
- Some practices blocked appointment slots to create time for reviewing online requests.
- Others extended staff hours or reduced available clinical sessions.
The survey was conducted between April 13 and May 7, 2026, and received responses from 330 GPs and 242 practice managers in England. Duplicate practice entries were removed. However, the survey was unweighted and described by its publishers as a snapshot rather than a scientifically representative study.
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Online Access Became a Contractual Requirement
Since October 1, 2025, GP practices in England have been required to keep their online consultation systems available throughout core hours, from 8 am to 6:30 pm.
The systems must allow registered patients to submit non-urgent appointment requests, medication queries and administrative requests. NHS England introduced the requirement to provide more equitable access by allowing patients to contact practices online, by telephone or in person.
The online tools are intended for routine matters. Practices must display guidance directing patients with urgent symptoms towards appropriate services.
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Digital Triage Can Reduce Time Available for Consultations
Every online request must be examined and assigned an appropriate response. This may involve arranging an appointment, providing clinical advice, directing the patient to another service or identifying symptoms requiring urgent assessment.
“Every single request needs to be checked by a GP to ensure potentially urgent cases are swiftly identified,” BMA GP committee deputy chair Dr Manu Agrawal said.
GP leaders argue that reviewing large volumes of digital requests can consume time that would otherwise be available for consultations. The difficulty becomes greater when patients use routine online forms to report symptoms requiring urgent attention.
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Workload Pressures Raise Patient-Safety Concerns
The BMA says practices require adequate staffing, funding and safeguards to manage online submissions alongside telephone calls and walk-in requests.
The safe-working guidance recommends structured clinical sessions and manageable limits on daily patient contacts. Excessive decision-making may contribute to fatigue, clinical errors, burnout and longer working hours.(1✔ ✔Trusted Source
Appointments in General Practice, June 2026
The organization also warns that remote access can encourage doctors to log in during evenings and weekends, extending the working day beyond scheduled clinical hours.
Patient-safety concerns may arise if an urgent request is incorrectly submitted through a routine form, if high request volumes delay review or if reduced continuity prevents a patient from seeing a clinician familiar with their medical history.
National Appointment Data Present a Mixed Picture
The practice survey reflects the experiences of participating GPs and managers, but it does not demonstrate that face-to-face appointments have fallen nationally.
NHS England Digital recorded 34.9 million general practice appointments in June 2026, with 60.2% conducted face to face. Of all recorded appointments, 45% occurred on the same day they were booked.
In response to the survey, NHS England said practices delivered approximately one million more face-to-face appointments in June 2026 than during the same month of the previous year.
Both findings can exist together: individual practices may reduce their in-person capacity while the national number rises because more appointments are being delivered overall.
The proportion of appointments conducted face to face can also decline even when their absolute number increases.(1✔ ✔Trusted Source
Appointments in General Practice, June 2026
Consultation Format Must Match Patient Needs
Online and telephone consultations can be suitable for administrative questions, medication reviews, follow-up discussions and conditions that do not require physical examination.
Face-to-face consultations remain particularly important when:
- A physical examination is required.
- Symptoms are complex or difficult to describe remotely.
- A new or potentially serious condition is suspected.
- Communication difficulties affect remote assessment.
- Safeguarding or continuity-of-care concerns exist.
Patients in England can contact their practice online, by telephone or by visiting in person. The practice team should assess the request and determine an appropriate response based on clinical need.(1✔ ✔Trusted Source
Appointments in General Practice, June 2026
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Digital General Practice Access Needs More Staff and Resources
The Department of Health and Social Care maintains that practices must continue offering face-to-face appointments alongside remote consultations. It says additional investment, GP recruitment and online services have improved access and patient satisfaction.
GP representatives do not reject digital access but argue that it must be supported by sufficient clinical and administrative capacity. Without that support, online systems may increase demand faster than practices can safely assess and manage it.
The challenge is therefore not choosing between digital and face-to-face care. It is ensuring that every request reaches the correct professional, through the appropriate consultation method, without reducing safety or exhausting the workforce.
References:
- Appointments in General Practice, June 2026- (https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/june-2026)
Source-Medindia