Managing the new contractual requirements on GP Access within your permitted contractual terms

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Update, 13 June 2023: we have now produced this video presentation which explains how these requirements affect practices.

Attention GPs and practice managers,

The BMA is the trade union with which the Government, through NHS England, negotiates GPs’ national contractual terms and conditions.

Notwithstanding months of negotiations, the Government has imposed new contractual patient access requirements on practices through statutory Regulations which come into force on 15 May. The BMA believes that these requirements are not achievable for many practices with current resource and workforce, and that practices who attempt to achieve the requirements may do so at the expense of clinician wellbeing and patient safety.

As a consequence, the BMA has issued clear guidance on your contractual obligations to be accessible to patients and, crucially, what you can do if you are challenged by your commissioner. I urge all GPs and practice managers to read this guidance which includes “protecting patients and clinical staff from the risks of decision fatigue, clinical errors, patient harm and clinician burnout by limiting clinical contacts to no more than 25 per day for each GP, and any excess demand beyond this being signposted to other settings such as 111, overflow hubs or urgent treatment centres”. This list is not exhaustive.

In addition I am writing to all of our ICBs seeking confirmation that a list of all wider commissioned services will be accessible to all GPs and practice teams on the Directory of Services. And that practices are provided with the contact details to whom patients can directly complain should they experience a breach in the provision of the service to which they were referred or signposted by the practice under these new Regulations in good time before the 15 May, when they come into effect.

With best wishes




Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs