GPs' strike threat over changes to how patients book appointments in England

GPs are threatening to launch an industrial dispute unless Wes Streeting halts major changes to how patients book appointments.

The Health Secretary has promised to “end the 8am scramble” from Wednesday by forcing practices in England to allow patients to request appointments online throughout opening hours from Wednesday. Currently practices can suspend online bookings when they get too busy and phone lines can remain engaged so some patients are unable to get through.

Planned changes to keep open online access were intended to free up phone lines for older people who need them but the British Medical Association (BMA) claims that without more resources it could quickly become a “critical patient safety issue”.

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The doctors’ union says it will “open the floodgates” and will launch a formal dispute if the Government does halt the plan in the next 48 hours.

BMA GP committee chair Dr Katie Bramall said: “The Secretary of State knows that when these changes come into effect it will likely lead to the creation of hospital-style waiting lists in general practice and reduce face-to-face GP appointments, as we'll be triaging a barrage of online requests putting patients at risk of harm as we try to find the urgent cases among the huge pile of unmet patient need that's out there.”

Mr Streeting is expected to address the doctors’ union in his speech at Labour Party Conference in Liverpool tomorrow.

The BMA wants practices to maintain the ability to divert online consultation requests to telephone and walk-in options if they are "overwhelmed". However under the current system this leaves many people struggling to get through to the practice.

The 2024 GP Patient Survey found that over 25% of people did not have a good experience of making a GP appointment the last time they needed one. The incoming Labour government warned that GP access has got so bad under the Tories that patients in some areas had got used to just going straight to A&Es.

What are the changes?

The change will likely mean that receptionists are no longer the gatekeepers to GPs ftom October 1.

The GP triage process will change in England so that practices are required to accept requests for appointments online, via the phone or for walk-ins from 8am to 6.30pm.

All requests for appointments will see patients provide details of their condition and the practice should get back to them within one working day. This should result in the offer of a GP appointment slot or referral to a pharmacist or other NHS service. In a minority of cases it could result in self care advice.

The change will mean GP practices can no longer ask that patients call back again tomorrow at 8am.

The BMA says online systems cannot distinguish between urgent and non urgent cases. The union said it agreed to the changes on the condition that “necessary safeguards” would be put in place to “avoid urgent clinical requests being erroneously submitted online” before the change was rolled out.

The BMA says that without more staff capacity then GPs could be taken away from face-to-face appointments to review the online requests for appointments.

If the change goes ahead the BMA will go into a technical dispute with the Government which is one of the first initial which could lead to a ballot to strike if it is not resolved.

Dr Bramall said: “We agreed to these changes on the condition that ‘necessary safeguards’ would be put in place before Wednesday 1st October. Mr Streeting needs to listen to us and understand how we believe GPs can deliver his ambitions safely.

“General practice is the leader in NHS tech innovation, we do everything online from systems to prescriptions, referrals and appointments. We’re not resistant to change, but we will be when the safety of patients and practice staff is at risk.

“The Government has 48 hours to change course, avoid this dispute, and keep to their promises.”