GP surgeries must give patients an appointment or referral the first time they contact their practice under the terms of a new NHS contract.
NHS England has imposed the new rule in a contract of employment for family doctors after talks with the British Medical Association (BMA) broke down.
According to the letter from NHS England, the updated GP contract says that patients should be offered an assessment of need, or signposted to an appropriate service, during their first contact with the practice.
It means that GP practices will no longer be able to request that patients contact the practice at another time, which could see the 8am scramble to secure a slot become a thing of the past. Practices have also been told they will need to offer automatic access to future patient records through the NHS app.
The contract letter, which was sent to GPs on Monday (6 March), was not agreed with GPC England, a BMA committee, which described the proposed changes to the GP contract as “insulting”.
The committee met Health Secretary Steve Barclay on Thursday to negotiate changes, but the BMA said Mr Barclay “flatly refused” to supply additional help to practices in the “tick-box exercise meeting”.
The BMA is now considering whether to ballot GPs for strike action Mr Barclay and NHS England added more stipulations around patient access but offered no extra funding for staffing.
Dr Kieran Sharrock, acting chairman of GPC England, said in a statement on Monday that ministers have focused on “eking out” more from practices without providing the necessary resources.
He said: “Without investment to do more, practices have to free up resources from elsewhere. This hasn’t been properly considered, ramping up GP workload, and without the support needed, will lead to more GPs leaving the profession.
“Ultimately, it’s our patients who suffer most, and this means more of them will be left waiting longer for the care they desperately need.
“It’s extremely frustrating to see a second GP contract imposition forced on the profession, especially one that does absolutely nothing to improve what is fast-becoming an irreparable situation for practices and their patients up and down the country.”
He added: “This contract is the result of a failure to listen to what GPs actually need, and totally ignores the calls for any extra support to help practices meet the rising costs of keeping their doors open.
“Despite warnings from GPC England, it also introduces more bureaucracy and arbitrary targets that only set practices up to fail and take GPs away from direct patient care.”
The majority of the Investment and Impact Fund – an NHS scheme to support primary care networks – £246 million, will now concentrate on improving patient experience of contacting their practice and receiving a response or being seen within the appropriate period depending on urgency. There will also be changes to payments for childhood vaccinations.
According to the BMA, GP practices in England delivered 329 million appointments last year - 17 million more than in 2019 - and 85% took place within two weeks of booking. The association also said England has lost more than 400 practices since 2019.
A spokesman for the Department of Health and Social Care said: “We’re committed to supporting GPs and are incredibly grateful for the work they do.
“The updated terms of the contract first agreed with the BMA in 2019 will ensure patients receive better care and get to see their GP quicker – allowing practices to employ more highly skilled and experienced nurses and mental health practitioners.
“There are 400 more doctors in general practice compared to a year ago, we are delivering almost 120,000 extra appointments every day and will shortly be setting out our plans to help primary care recover further and faster with more support for staff and for patients.”