I am writing to all colleagues in anticipation of the changes in the Regulations due to take
effect on 01 October, negotiated as part of the 2025/26 GP Contract, but whose implementation was deferred to allow further negotiation between GPC England and NHS England. This reflected GPC England’s substantial concerns that such implementation poses a risk to the safe delivery of patient care. That negotiation is continuing, but colleagues should note that the letter of 19 August 2025, from NHS England, that all practices should have received, presents the Regulations currently unaltered by any further agreement either in terms of the wording or process of implementation.
In terms of the three contractual elements, these are as below:
- The practice on-line consultation platform should be switched on for the duration of core hours (that is, 8am-6.30pm)
- The link for You and Your General Practice, should be available via your practice website, and
- GP Connect Access Record (HTML and Structured) and Update Record must be enabled within GP practice clinical systems.
Considering these issues in more detail:
You and Your General Practice (YYGP)
This document is intended to be an amalgamation of factual information for patients in terms of obtaining care and services from their registered GP practice. It is also available via the NHS England link, in multiple languages. It includes a section on how you can help your General Practice which colleagues can adapt in terms of expectations. YYGP does largely avoid the “rights and responsibilities” type of phraseology and the advice within it does follow the contractual position, albeit providing a shorter, simplified explanation of some issues, such as NHS registration.
There may be some minor textual amendments prior to the final version being available on 01October and at that point it would be helpful for practices to ensure that, for example, their complaint and registration policies, align with the advice provided to patients via the YYGP.
GP Connect Access Record requirement
This issue is still subject to further negotiation; and I appreciate many practices will have switched off ‘GP Connect’ as part of the BMA Collective Action campaign, which was supported by the LMC, and maintained that position since.
Although 01 October, which in parenthesis is also a celebratory day for a number of reasons, being, for example, designated International Day of Older Persons by the United Nations, as well as being the anniversaries of Walt Disney World first opening (1971) and the International Space Station receiving its first inhabitants (2001) as well as the death of Alexander the Great (331BC), is not far off, at present the LMC recommends practices take no action. This is a straightforward enablement in terms of practice IT and the LMC suggests waiting until the outcome of current negotiations is available.
Online Consultation requirement:
This is significantly the most challenging issue: GPC England has made it clear to NHS England its concern that practices will be overwhelmed by workload demands created or facilitated by such a change, and that it will be impossible for clinicians to safely deliver safe care to patients. This challenges the principles of Safe Working Guidance, which has enabled many practices to manage clinical workload efficiently, yet without the risks associated with an uncontrolled demand and workload.
NHS England has agreed that, in implementing this arrangement, a distinction can be made between routine and urgent online requests, with the latter patients being diverted to telephone or F2F access routes. However, clearly there are issues in terms of reliably distinguishing between the two and managing the remaining workload.
Obviously, there are practices who do maintain their online platforms during significant proportion of core hours, or throughout it, however, the LMC believes practices should retain their control over this platform to take into account demand and capacity mismatch and be able to independently switch their online platform off. It is also somewhat disingenuous of NHS England to claim over 80% of practices had their online platforms switched on at the end of March via Capacity and Access Improvement Plan (CAIP) claims in the PCN DES, since both NHS England and ICBs are aware the wording of both the 2024/25 and 2025/26 Regulations did not require practices online platform to be open continuously throughout core hours during the financial year to be eligible for such funding. The LMC has previously provided advice on this point.
GPC England, and SSLMCs, has received sufficient feedback on this issue to make it clear that a significant proportion of colleagues do not believe it is safe to implement this process. The issue, with any negotiating progress that has been achieved, will be debated at GPC England’s meeting on 18 September 2025. It is already clear, from preliminary discussions, that this is an issue on which a proportion of GPC England members believe GPC England should vote to enter dispute with the Government, despite the many implications of such a decision.
The LMC would therefore recommend practices do take steps to enhance the way they provide online access to patients: there are multiple resources available to assist practices in this, at: NHS England > Resources.
However, clearly further updates will be available prior to the 01 October date.
I hope this background is helpful.
Dr Julius Parker, Chief Executive