From October 1, 2025, every general practice (GP) surgery in England faces a seismic shift: all must now keep their online consultation tools running throughout working hours, making it possible for patients to request appointments, ask about medications, or handle admin queries without picking up the phone. The government’s stated aim is to end the notorious “8am scramble” for appointments and bring the NHS fully into the digital era. But for many doctors and patients, the move has sparked a heated debate about access, safety, and the future of primary care.
The requirement, announced in February as part of the new GP contract for 2025-2026, means online booking and consultation tools must be available from 8:00 a.m. to 6:30 p.m., Monday through Friday. According to the Department of Health and Social Care (DHSC) and NHS England, this upgrade will be subject to “necessary safeguards in place to avoid urgent clinical requests being erroneously submitted online.” Still, not everyone is convinced those safeguards are ready or that the system can cope with the expected surge in demand.
Care Minister Stephen Kinnock has been a vocal champion of the change. “We promised to tackle the 8am scramble and make it easier for patients to access their GP practice – and that’s exactly what we’re delivering,” Kinnock told Digital Health. “We are bringing our analogue health service into the digital era, giving patients greater choice and convenience. We’ve learned from GPs who are already offering this service and reaping the rewards.”
He points to government investment as proof of commitment: an extra £1.1 billion for general practice—the largest increase in over a decade—and 2,000 new GPs hired across England. NHS England has also rolled out resources to help practices adapt, including peer support programs and case studies from clinics already operating online consultations throughout the day. The hope is that freeing up phone lines and moving more requests online will make it easier for everyone to get the care they need, when they need it.
Polling from the Health Foundation and Ipsos in September 2025 found that the public’s top NHS priority is easier access to GP appointments. Online patient submissions have surged, with government figures showing nearly six million online requests in July 2025, up from 3.4 million a year earlier. One London GP surgery that adopted all-day online requests reported a dramatic drop in wait times—from 14 days to just three—with 95% of patients seen within a week.
But if the government is optimistic, many GPs and patient groups are wary. The British Medical Association (BMA) has entered into a formal dispute with the government over the new rules, warning that the promised safeguards have not materialized and that no extra staff have been brought in to handle what it predicts will be a “barrage of online requests.” The BMA fears the change could create “hospital-style waiting lists in general practice” and reduce face-to-face appointments, with serious consequences for patient safety.
Dr. Katie Bramall, chair of the BMA GP committee, was blunt in her criticism. “At the start of this year, the government promised GPs across the country that they would implement the necessary safeguards that would enable practices to operate safely and prevent patient harm with online consultations and other IT changes. Unfortunately, this has not happened,” she told The Independent. “Despite repeated warnings of the potentially significant risks, the government has refused to listen and act over GP concerns for patient safety. General practice online systems now risk being inundated with both non-urgent and urgent patient queries, leaving practices – regardless of size and the volume of queries they handle – to manage the fallout.”
She added, “We can only hope that no life-threatening issues are missed or delayed, but it’s a very real and present danger when we are handling over a million appointments each day nationwide.” Bramall also noted that GPs are “terrified” to be forbidden from diverting patients to phones if swamped by online requests, emphasizing that their main worry is “patient safety.”
Other frontline doctors echo these anxieties. Dr. Elpitha Bruce, a GP in Plymouth, told BBC News, “It could put unnecessary extra pressure on already overworked staff that are doing their best.” Dr. Hugh Savage, who chairs the Kernow Local Medical Committee in Cornwall, said that while online access was meant for “routine problems,” the lack of robust safeguards means practices now must “monitor this all day.”
Patients themselves are divided. Simon Culley, from Healthwatch in Devon, Plymouth, and Torbay, said some people struggle with online booking and worry about being “left to die.” A recent Healthwatch Cornwall survey of over 2,200 people found that 77% still prefer face-to-face services, while just 7.2% favor online access. Debbie Gilbert, the group’s chief executive, insisted, “It shouldn’t matter where you live, we all should have the same standardised level of care across Cornwall.”
Patient groups are clear: online booking should be an option for everyone, not a privilege for a tech-savvy few. “Many people are worried they could be left to die and that’s so disheartening and heart-breaking to hear that from patients,” Culley said.
The government, for its part, insists that the transition will not come at the expense of traditional care. Prime Minister Sir Keir Starmer, speaking at the Labour Party conference, promised that face-to-face consultations would “never” be taken away from those who want them. He painted a picture of convenience and accessibility: “Think about a single mum juggling kids, trying to find time to speak to a specialist, or someone in their later years, living in a rural community miles from a hospital, who needs a check-up for a suspected eye condition. Why not have a doctor see you at home in your living room on an iPad, talking to you? No queues, no three-hour bus trip, no cancellation letters arriving after the appointment date.”
The government’s ambitions extend beyond GP surgeries. At the same conference, Health Secretary Wes Streeting announced the launch of an NHS “virtual hospital” from 2027, allowing patients to consult specialists from home or work. The government estimates this move will generate an extra 8.5 million appointments over three years, with Starmer promising NHS Online will deliver “millions of appointments” digitally.
Yet, even as some GP practices report positive results—such as reduced wait times and improved staff morale—others worry about “uncontrolled demand” and the risk that urgent cases could slip through the cracks. Dr. Duncan Gooch of the NHS Confederation acknowledged these fears but said that for some clinics, “managing demand and providing better access has reduced stress on staff, conflict with patients and created a positive environment where job satisfaction is high.” Still, he emphasized, “we still need more investment into general practice and GPs to help stem the increasing turnover and provide patients with the service they need.”
As England’s GP practices adapt to this new digital mandate, the challenge will be ensuring that greater convenience does not come at the cost of care. The debate is far from over, but one thing is clear: the way patients access their family doctor is changing—and everyone, from ministers to medics to patients, is watching closely.
