Regions have received the below national direction/narrative to support the confirmed line regarding Core Opening Hours for General Practice. This outlines that the changes regarding ‘contact with the practice’ for 2025/26, which were agreed with the BMA’s General Practitioners Committee England (GPCE) have not altered the requirement regarding telephone and in-person access in core hours.
GP Practice opening times
The changes regarding ‘contact with the practice’ for 2025/26, which were agreed with the BMA’s General Practitioners Committee England (GPCE) have not altered the requirement regarding telephone and in-person access in core hours. Core hours have been well established since 2004. Core hours refers to the period beginning at 8.00am and ending at 6.30pm on any day from Monday to Friday except Good Friday, Christmas Day and bank holidays.
Since 2023/24, the regulations and the contract have required that a patient making contact with the practice should know on the same day how their presenting issue will be handled. That does not necessarily mean the practice has to see or treat the patient on the same or next day, rather the patient should know how their presenting issue will be managed by the practice, which could involve arranging an appointment for the patient on another day, or signposting to another appropriate service, such as Pharmacy First. 111 would not constitute an appropriate alternative service; 111 provides a triage function.
Appropriate triage of the patient’s request should be undertaken. The patient should not be expected for example, to call back the next morning. Providing the patient with an automated acknowledgment that their request has been received (without active triage by care navigator/ reception staff) would not meet the contractual requirement. Signposting patients to other services via automated messages (including IVRs) without active triage would not meet the contractual requirements.
Active triage does not necessarily demand that a GP must specifically be on site to undertake or assist in any required activity. Flexibility must be retained to allow for GPs to undertake visits for example.
Whilst practices may sub-contract clinical services under the terms of their contract, those subcontracted services must meet the reasonable needs of patients and be capable of providing the same level of services, which would include seeing a patient in person if needed, answering telephone calls, responding to routine appointment requests, or responding to online consultation submissions. Subcontracting arrangements should be discussed with the commissioner on a practice by practice and case by case basis. It is not appropriate for commissioners to approve or agree to sub-contracting en-masse e.g. across wide geographies (ICB / sub-ICB level) for example during lunch or at either end of core hours (e.g. 18:00 – 18:30) or to agree such arrangements on a long term or regular basis. Provisions still remain for practices to agree temporary local variations to their normal service provision to allow for activities such as practice learning time but this should not be a blanket regular arrangement.
Relevant regulation here https://www.legislation.gov.uk/uksi/2015/1862/schedule/3/paragraph/4
Contact with the practice
4.—
- The contractor must take steps to ensure that a patient who contacts the contractor—
(a)by attendance at the contractor’s practice premises;
(b)by telephone;
(c)through the practice’s online consultation tool within the meaning given in regulation 71ZD(2); or
(d)through a relevant electronic communication method within the meaning given in regulation 71ZE(3), is provided with an appropriate response in accordance with the following sub-paragraphs.
- The appropriate response is that the contractor must—
(a)invite the patient for an appointment, either to attend the contractor’s practice premises or to participate in a telephone or video consultation, at a time which is appropriate and reasonable having regard to all the circumstances;
(b)provide appropriate advice or care to the patient by another method;
(c)invite the patient to make use of, or direct the patient towards, appropriate services which are available to the patient, including services which the patient may access themselves; or
(d)communicate with the patient—
(i)to request further information; or
(ii)as to when and how the patient will receive further information on the services that may be provided to them, having regard to the urgency of their clinical needs and other relevant circumstances.
- The appropriate response must be provided—
(a)if the contact under sub-paragraph (1) is made outside core hours, during the following core hours;
(b)in any other case, during the day on which the core hours fall.
- The appropriate response must take into account—
(a)the needs of the patient, including the need to avoid jeopardising the patient’s health;
(b)where appropriate, the preferences of the patient ; and
(c)any benefits to the patient of providing for continuity of the health care professional involved in their care and treatment.