Dispute between GPs and the Government

Our dispute centres on three key promises made by Government, which were conditions of GPC England’s acceptance of the 2025/26 GMS Contract:

• 1. Further to the Secretary of State’s written commitments (March) and (August), the profession must have full confirmation of plans for negotiations on GMS (general medical services) contract renewal with transformational investment within this Parliament, i.e. by 2029. 
• 2. The unsafe contract change that came into effect on 1 October 2025, which now compels practices to make online consultations available to patients throughout core hours (08:00 – 18:30) without the promised necessary safeguards which DHSC/NHSE had committed to.
• 3. The contract change that came into effect on 1 October 2025 compelling practices to switch on access to update record via GP Connect for other NHS providers, without remedying the concerns of the Joint GP IT Committee of the RCGP and BMA, and without indemnifying the data sharing liabilities of practices in their role as the data controller for the GP patient record.

In agreeing the 25/26 contract in March 2025, Government, DHSC, and NHSE committed to working in good faith with the BMA GP Committee (England) and others to ensure necessary patient and staff safeguards were in place before bringing in these contractual changes. This was not done; the safeguards are still not in place; these promises have been broken.

The Government falsely claims it was always the intention for practices to implement the necessary safeguards. This is a misleading narrative that ignores the fact that general practice is the only sector of the NHS that is fully electronic, and which leads the way in innovation for online records, prescriptions, referrals, and investigations. 

Meanwhile, the DHSC’s own Health Services Safety Investigations Body says that issues with online consultation tools ‘can put the safety of patients at risk’ without the safeguards we have long proposed. By failing to act, the Government is wilfully ignoring evidence from its own health services safety body.

The Ten-Year Health Plan also ignores GMS investment but instead talks of novel contractual reform with single and multi-neighbourhood provider contracts. Furthermore, we have seen the DHSC enter a six-month consultation reviewing the Carr-Hill funding formula – this should be part of a key negotiation with the BMA around GMS renewal. However, breaking with 22 years of practice following a referendum of the profession in 2003, the Government has unilaterally decided to consult multiple stakeholders on 26/27 GP contracts rather than negotiate with the GPCE as the representatives of GP practices. 

On behalf of all practices in England, we therefore dispute:

• 1. That the 1 October 2025 contract changes are safe for patients and staff and
• 2. That the Government intends to deliver desperately needed General Practice resource restoration to ensure safe and continuous patient care for the communities GPs serve.

Practices therefore do not agree with the 1 October 2025 contract changes and are currently working under protest so as not to fall foul of their new contractual obligations. The GPCE chair has written to the Secretary of State for Health and Care to confirm the above.

Next steps

The GPCE chair has written to the Secretary of State for Health and Care regarding what is now needed to exit dispute and address the concerns we have detailed about the 1 October contractual changes: 

• DHSC must stop delaying and provide written confirmation of the timeframe for negotiations and commit to the much-needed increased funding envelope for GMS contract renewal within this Parliament.
• DHSC and NHSE must secure the technical solutions within online consultation tool platforms and GP Connect, which prevent the submission of urgent online consultation requests and unsafe / illegal use of patient data.

Without these assurances, the dispute cannot be resolved.

We are exploring all possible next steps. We continue to seek collaborative solutions as these problems are remedial, not inevitable. Despite the unilateral decision by DHSC to change the annual GP contract consultation and negotiation process for 2026/27, breaking with established custom and practice, it's not too late for the Government to remedy relationships as we think about the future of general practice.

Loss of 25% of general practice contracts and GP workforce

Since 2010, a staggering 25% of GMS contracts have been lost. Despite a growing population, we have almost 1,000 fewer GPs than a decade ago – a shortfall the Health Foundation, estimates is actually over 6,000. Years of under-resourcing have set the partnership model up to fail.

The headline investments of 2025-26 do not paint a full picture; much of this funding returned to the Treasury to cover mandatory increases in National Insurance and the Living Wage. Consequently, we face a crisis where GPs are struggling to find work whilst patients clamour for access and continuity of care.

We are standing up to protect community NHS GP practices. We demand a long-overdue restoration of resources to ensure GPs in every part of England are seeing patients and not searching for enough work.  The time for broken promises and Government delay is over.

Online consultations

A BMA survey of more than 1,300 GP practices in England has exposed significant concerns about the Government’s new online requirements introduced on 1 October 2025. 73% of responding practices said they had to change how they work because of the contract change, and many reported negative effects on both patients and staff. Read more on the survey results.

What practices need to do

Practices must comply with the 1 October 2025 contractual requirement to avoid the risk of receiving remedial or breach notices from ICBs (integrated care boards). They must have an online consultation tool that is available to registered patients throughout core hours (8am – 6.30pm), which allows patients to make non urgent / routine appointments requests, medication queries and administrative requests. For more information, refer to our Online Consultation Tools page. 

Our concerns

GPCE is concerned that patients continue to have the means to accidentally submit urgent requests or queries online, which poses an unacceptable level of safety risk for patients and practice staff. This is why the agreed necessary safeguards are so vital to avoiding that happening.

GP Connect: Update Record and Access Record Structured

What practices must do

Practices must also comply with this requirement or risk receiving breach notices. They must allow third parties (beginning with community pharmacists) to send coded and free-text information for direct incorporation into the GP record via the GP Connect: Update Record functionality. As with any information submitted, GPs will be required to check and accept this information before it becomes part of the record, ensuring, in particular, the coded entries are appropriate and do not leave the clinical system flagging concerns about the patient, for example, a blood pressure out of target, without addressing these. 

They must also ensure that information held within the record is made available to appropriate third parties to access for the purposes of direct care.
 

Our concerns

GPCE is concerned that an increased flow of traffic both in and out of the GP record will increase the risk of data breaches, with GPs held liable for errors that are not their fault. These breaches may also pose a risk to patient safety where sensitive information is made available to patients that they would not otherwise have seen. It will also increase demand on practices to resolve data flows, thereby adding to the pressure being placed on general practice across the country.