A BMA survey finds that urgent and emergency requests have been submitted online, which risks patient harm and increases staff stress and anxiety.
More than half of GP practices in England have reported an adverse impact on patient care from changes to online access.
At the beginning of October, the government introduced changes to how patients contact their GP practice via online platforms. In what it dubbed an attempt to “end the 8am scramble”, the government required all practices to provide continuous online, telephone and in-person access throughout core hours.
More than eight million people submitted their GP request online during October 2025, up more than a fifth (21%) on the previous month and up more than two-thirds (68%) on last year, according to figures published at the end of November by NHS England.
As Ric Thompson, senior vice-president of health and care at OneAdvanced, warned in Healthcare Today at the time: “The proposed “unlimited” online consultation requirement threatens patient safety, staff wellbeing, and the very fabric of primary care.”
Several months on, that is exactly what the reality has proved to be. In a BMA survey of more than 1,300 practices, GPs have confirmed that urgent and emergency requests have been submitted online, which risks patient harm and increases staff stress and anxiety, compounding the existing workforce pressures felt across GP practices in England.
“Over four in ten are having to reduce the number of GP appointments they can offer to their patients so they can manage/triage online requests and queries instead. If the government had chosen to listen to us and work with us, we could have made this so much more of a success,” said BMA GP committee chair Katie Bramall.
Risk of patient harm
More than one in five practices in England responded, and over 1,300 unique practice responses were recorded. Of these, the majority (73%) had to change their ways of working due to the contract change.
A significant proportion of practices (42%) have had to reduce face-to-face appointments – all reducing the time patients spend with their family doctor. A similar proportion of these practices (45%) said they’ve had to redeploy staff to accommodate the changes. More than half (55%) of these practices had seen a negative effect on patient care. Despite GPs warning of the risk of patient harm, 74% of these practices said they’d seen an increase in workload, 68% reported an increase in stress, and 54% said there was an increase in working hours.
In the responses to the survey, some practices shared their experience anonymously.
“Patients submitting requests/queries for things that they need to go to A&E for at all hours of the day – you have to be vigilant to spot these requests and quickly divert them to A&E. If we are not manning the inbox constantly, these will be missed,” said one. “Patient submitting request at 6.20am with high fever and now bedbound, being unable to move and breathless. Required an ambulance to take to hospital to treat for sepsis,” said another. “When the volume of requests becomes unmanageable, triage becomes harder, and the risk increases that ‘false routine requests’ that are actually urgent are not picked up in time,” said a third.
