BMA warns GP online consultation changes may cause waiting lists

The British Medical Association (BMA) has warned that allowing patients to book online GP appointments throughout the day could cause a spike in doctors’ workloads and create waiting lists.

Under changes to the GP contract that come into effect from October 2025, practices must keep online consultation tools open for non-urgent requests, medication queries and admin requests throughout core hours. Currently, practices can switch these tools off as required to manage demand.

BMA leaders say that this move will “change the way that many patients choose to access routine non-urgent care” and risks a spike in workload for overstretched GP practices.

Updated guidance from the BMA England GP committee states: “GPC England has been clear to government with its major concerns over making the use of online consultations available to all patients throughout opening hours.

“At a time when we desperately need to expand GP numbers and premises, we have been frank with NHS England, DHSC and government that this contractual ask risks the creation of waiting lists within our practices.”

The guidance makes clear that routine, non-urgent appointment, medication or administrative requests do not require same-day triage, review or action and urges practices to make this clear to patients.

However, the BMA previously said that there is “no practical way” to completely avoid urgent requests being made through the system – and said it is “working with online consultation suppliers to create safeguards to better secure safe practice for GPs, their practice staff and patients”.

Dr Rob Barnett, medical secretary at Liverpool Local Medical Committee told GPonline that plans to force practices to keep online consultation tools open throughout core hours are a “fiasco”.

“I think it’s a very clever way of getting patients to just give up and either do nothing or go somewhere else, which is really worrying and not very good when one looks at the increasing health inequalities.

“Those who are [digitally] articulate, savvy and know what they’re doing will get through the system.

“Those who can afford it will do something else and those who can’t afford it and are [digitally] illiterate will get left behind. That’s the worst-case scenario,” Barnett said.

The BMA guidance also warns that current levels of patient contacts per GP per day in England are “significantly more” than its recommended safe limit of 25.

It explains that waiting lists in general practice may be the only way to keep moving closer to this limit as practices manage the impact of the change in rules around online tools.

Meanwhile, figures published by NHS England in February 2025 showed that the number of practices which patients can join online had more than doubled in 12 months, with more than 6,150 practices supporting registration through the NHS App, NHS.uk or surgery websites.