Alongside these arrangements, the 2026 to 2027 contract continues to place additional pressure on general practice in relation to access. This is despite NHS England and DHSC being warned that general practice is already operating at saturation capacity, and that the priority should be making arrangements for patients who cannot be seen within existing GP capacity. Sustained investment in general practice remains necessary.
There were also clear warnings that increasing contractual requirements around access would risk creating waiting lists for routine appointments within practices. This is an important consideration when managing the ongoing mismatch between capacity and demand, particularly in the context of regulatory changes. The LMC continues to support the use of BMA Safe Working Guidance, including in relation to appointment length and safe daily consultation limits.
Some of the contractual requirements are likely to reflect existing practice, including:
- publishing opening times for all access routes on the practice website, in patient leaflets and within the premises
- not asking patients to recontact the practice on another day instead of providing a response, which may include offering an appointment on a later date
However, other requirements are likely to have a more significant workload impact, including:
- no cap on the number of online requests that can be submitted each day
- the expectation that patients assessed as having an urgent need receive a same day response, noting that this does not necessarily mean resolution on the same day
The Regulations are being amended to clarify that an “appropriate response” does not have to be provided within the same day, but to within the next day core hours period. This is intended to avoid any implication that practices are contractually required to work beyond core hours. However, it is clear this is what most GPs (and other staff) are already having to do.