Our concerns centre on the contract changes that came into effect on 1 October. Specifically, those changes that now compel practices to make online consultations available to patients throughout core hours (08:00 – 18:30), as well as switching on access to update record via GP Connect for other NHS providers. The necessary safeguards, which DHSC and NHSE committed to working with the BMA GP Committee (England) and others to implementing before bringing in the contractual changes, have still not been put in place.
On behalf of practices in England, we therefore dispute that these contractual changes are safe for patients and staff. The GPCE chair has written to the Secretary of State for Health and Social Care to confirm this.
To end this dispute, we are calling on the Government, by 1 November 2025, to:
- request NHSE urgently provides written assurance that no practice will risk a breach notice should the practice be forced to divert urgent same-day patient contacts to telephone and walk-in due to overwhelm of patient need exceeding available clinical capacity
- request NHSE urgently meets with GPCE and online providers to secure solutions for their platforms which preclude the submission of urgent online consultation requests
- request NHSE urgently work with the JGPITC to reach rapid solutions to resolve outstanding concerns as articulated in their written statement on GP Connect, and provide practices with indemnity cover for data breaches by other NHS and third-party providers
- demonstrably focus on GMS contract renewal, with transparency regarding funding envelopes for GMS 2026/27; for new GMS; and for novel contracts within the 10 Year Health Plan, swiftly confirming the roadmap regarding timelines for such renewal and investment.
Brief timeline for the dispute
NHSE/DHSC initially proposes a requirement for practices to have online consultation tools switched on during core hours
Meetings with NHSE/DHSC firm up proposal to amend the GMS Contract to explicitly require that online consultation tools are available for patients to make administrative and clinical requests at least during core hours. This would not mandate that GPs address every case immediately. A stated red line for GPCE being the requirement that patients making contact within core hours, would be triaged so that patients understand how their response will be dealt with.
GPCE concerns were also shared with the Minister of State for Care.
Further meetings with NHSE/DHSC at which the red line for the profession because of concerns around capacity and safety were restated.
GPCE set out its concerns in a letter to NHSE/DHSC.
Consultation closes and the package is recommended to GPC England on 27 February. NHSE/DHSC writes to profession on 28 February confirming that 1 October 2025 contract changes will be subject to necessary safeguards in place to avoid urgent clinical requests erroneously submitted online.
GPCE chair and deputy chair (with IT portfolio) write to NHSE and DHSC to confirm the potential drastic impact of the administrative, information governance and clinical liability burden placed on practices and, that experience had shown it takes times to implement policy like the ones related to online consultation and GP Connect. Suggestion of recurring meetings every two weeks.
Letter sent to SoS flagging ongoing substantial clinical governance and data protection concerns around online consultation requests and GP Connect (Update Record) by other NHS providers.
Letter sent to Minister of State for Care thanking him for his words of reassurance around expectations for online consultations from 1 October 2025. He did not want practices to be overloaded and did not expect every practice in England to do exactly the same thing at exactly the same time.
17 September 2025:
GPCE wrote to Minister of State for Care demanding safeguards be implemented before the changes to online consultations were imposed.
19 September 2025:
Further letter to Minister of State for Care and SoS seeking a deferral of the contractual changes.
Minister of State for Care responds to GPCE chair's letters confirming that the 1 October contract changes regarding online consultation requests do not require an immediate response. Practices instead retain discretion to triage and prioritise based on clinical needs as they do for telephone and walk in queries.
1 October 2025
GPCE wrote to the Secretary of State for Health and Social Care and the Minister of State for Care confirming that GPC England had now entered into formal dispute with the government.
Compliance with contractual changes
From 1 October 2025, to ensure compliance with new contractual requirements in the 25/26 contract agreement in March 2025, and to avoid the risk of receiving remedial or breach notices from ICBs, practices must:
- have an online consultation tool, which is available to registered patients throughout core hours (8am – 6.30pm), to allow them to make non urgent / routine appointments requests, medication queries and administrative requests and
- that GP Connect (Update Record) functionality is enabled.
These contract changes only apply to practices that have agreed to the changes or received a notice from their ICB notifying them that the changes will automatically apply to their GMS/PMS contract. Notices from ICB must give at least 14 days’, and the variation(s) occur, regardless of whether a practice signs the notice or not, after the notice period.
New guidance
- Regulatory changes for 2025/26: This guidance explains the 2025/26 regulatory changes and the patient contact clauses from 2023/24. We provide advice on how to remain compliant in relation to the three modes of access: walk-ins, telephone contact, and online consultations.
- Managing patient care safely from 1 October: This guidance provides practical advice on managing patient care safely, including workflow and triage review; considerations on the waiting lists for routine care; and reminders from the BMA safe working guidance handbook.
- Your practice charter
- Setting up online consultations and appointments
- GP Connect Update Record Summary
- Waiting lists in General Practice
- Choosing an online GP consultation platform
- Guidance on demand and capacity
- FAQs for 1 October 2025 online consultations
New resources
- Template Letter from GP practices to ICBs regarding 1st October changes to contract on online consultations
- GP online consultations poster (PDF)
- GP online consultations poster (word version)
- Downloadable graphics: graphic 1, graphic 2, graphic 3
- BMA branded template for GP notification to ICB of patient safety concerns related to online access
Campaigning on the 2025/26 contract and the new GP contract
We have written to the Government and the NHS on numerous occasions. See our most recent engagement or view our latest engagements first:
- 15 Sept - Joint GP IT Committee position statement on GP Connect: Update Record. Following the 3 September meeting, the Joint GP IT Committee issued a statement on the current state of GP Connect: Update Record, shared with NHS England in light of plans to make this functionality a requirement.
- 30 July - GP premises services charges. In our letter to Karin Smyth MP, the minister responsible for land and estates, we raised the ongoing issues over service charges levied by NHS Property Services (NHSPS) and Community Health Partnerships (CHP). We have requested a meeting to explore constructive solutions.
- 22 July - The future of general practice. We wrote to Stephen Kinnock MP in relation to the future of general practice and requesting confirmation of future funding envelopes, a roadmap for GMS contract renewal and feforms to reimbursement schemes. We also call for extended indemnity cover and a clear government commitment to GP leadership in neighbourhood-level care delivery.
- 28 July - Changes to online access and GP connect software. We wrote to Helen Vernon, Chief Executive NHS Resolution, regarding changes to online access and GP connect software and highlighting risks of unlimited online requests and its pressure on an overstretched GP workforce. We asked NHS Resolution to underwrite liability for patient harm and data protection breaches from nationally mandated systems to better protect GPs adopting new technologies.
Mind the gap - local action and safe working guidance
Local action guidance to address commissioning gaps
GPCE urges all colleagues to prioritise safe working and raise commissioning gaps or failing pathways with LMCs and ICBs (Integrated Care Boards) for local renegotiation. Practices must be properly resourced for the care they provide to ensure patient care is sustainable. Any unfunded work should either be resourced, or after LMC consultation, served notice to ICBs. LMCs play a central role in securing fair outcomes supported by our national advice. Refer to our guidance on local action for GPs and secondary care colleagues in England for further information.
Safe working guidance
Our safe working guidance remains in place and will be updated with contractual changes. Requirements like e-consultations, fit notes, or medication queries do not oblige GPs to offer unlimited capacity that compromises safe patient care.
Template letters for workload management
Template letters are available to help practices manage workload and limit capacity to deliver safe, high-quality care.
Key headlines for the 2025/26 GP contract
- £969 million new investment uplift – comprises £889m additional core contract funding and £80m for use of e-RS advice and guidance between GPs and consultants
- This investment is on top of the £433m added to the contract during autumn last year
Listen to the GPC England Officer team discuss the detail of what has changed in the GP Contract and funding for 2025/26. The guidance on the 2025/26 contract page contains more information.
2025/26 DDRB award FAQs
The Government has accepted the Pay Review Body (DDRB) recommendations for 2025/26, which includes a 4% uplift for NHS contractor/partner GPs as well as NHS practice-employed salaried GPs.
View our comprehensive FAQs to help you understand the implications of the pay uplift and how it applies to your practice.
This uplift is inclusive of the 2.8% public sector pay assumption already included within the initial contract agreement, meaning the pay award will result in a further aggregate 1.2% uplift to the pay elements of Global Sum.
In addition, 4% uplifts are being applied to ARRS maximum reimbursable rates, SFE (statement of financial entitlements) locum cover reimbursement payments, educational allowances, GP trainer grants, Fellowship funding, the profit element of the dispensing fee scales, and the GP Educator pay scales.
Uplifts are backdated to 1 April 2025 and funds should appear in your August practice payment. LMCs are being encouraged to contact ICBs to ensure and claims already made in this financial year will be adjusted retrospectively.
NHS 10 Year Plan and neighbourhood health providers
In July 2025, the Government released its 10 year plan for the NHS. The BMA contributed actively, calling for stronger recognition of doctors’ role in delivering a sustainable NHS. Read our comprehensive submissions and find out what the 10 Year Health Plan says on BMA priority issues.
GPC England will be discussing GP facing aspects of the plan with the Government, DHSC and NHS England in due course.
Current guidance for GPs in relation to the 10 year plan
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Responding to blueprint for new ICB model
NHS England has published a draft blueprint for a new model for ICBs. We have summarised the proposed changes and set out the impact of these for general practice, exploring key issues that practices and LMCs will need to consider.
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National Neighbourhood Health Implementation Programme guidance
NHS England has launched the National Neighbourhood Health Implementation Programme (NNHIP). GPCE has produced a brief document (Focus on NNHIP) outlining the programme, the threats and opportunities involved and a checklist of key questions and issues for practices and those thinking of signing up.
Following the shift of care into the community via the new ‘neighbourhood health’ schemes, GPC England has also produced guidance setting core principles on out how GP practices and GP federations should engage with this and operate in an ethical, constructive and supportive manner.
