National Changes to GP Appointments and Hospital Referrals

National Changes to GP Appointments and Hospital Referrals

There are several national changes to the GP contract that will affect how GP practices across England manage appointments and hospital referrals from April 2026.

These changes have been introduced nationally and apply to all GP practices. As your GP practice, we feel it is important to explain openly how these changes will affect the services we are able to provide, and to share our concerns about the impact they may have on patient care.

General practice has been under increasing pressure for many years. Work that was previously carried out in hospitals is increasingly being delivered in primary care, often without the additional resources needed to support this. At the same time, there is increasing need for appointments and monitoring as people get older and have more chronic health conditions being treated.

We would like to recruit additional staff to help manage this increased workload and the
changes outlined below. However, without a corresponding increase in funding, this is
becoming increasingly difficult.

Changes to Appointments

One of the main changes in the new contract is a requirement for practices to triage all patient requests before booking appointments. This means that whenever you contact the practice for help — online, by telephone or in person — your request must first be reviewed and prioritised before an appointment can be arranged.

Our reception team will need to take information about your problem so that the doctors can triage your request appropriately. If you don’t wish to give information to the receptionist, you can submit a SystmConnect request instead.

While the aim of this system is to prioritise patients with urgent needs, it also requires
significant GP time to review requests.

At our practice, we estimate that this requirement will reduce available GP appointment time by about 10 hours per week, as GP time will need to be used to review and assess patient requests instead of seeing patients directly.

As a result, of the contractual  changes in October 2025  we  introduce a waiting list for routine GP appointments. With the further changes  from 1st April 2026. Patients with non-urgent problems may therefore need to wait longer to be seen. Patients with urgent medical problems will continue to be prioritised.

Changes to Hospital Referrals

There are also changes to how patients are referred to hospital specialists. Under the new
arrangements, GPs are expected to make greater use of a system called Advice and Guidance,
where a GP asks a hospital consultant for advice before making a referral.

This may mean:

• Referrals may take longer to arrange
• Consultants may advise your GP on treatment instead of accepting a referral
• Additional tests or information may be required before referral
  Preparing and reviewing these requests also takes additional GP time, which further reduces the
  time available for appointments.

Our Commitment to You

We want to reassure you that, despite these changes, we will continue to do everything we can to provide a high standard of care for our patients. However, these changes have been introduced nationally and were not agreed locally by practices. The professional body representing GPs, the British Medical Association (BMA), has not agreed to the new contract and remains in dispute with the Government.

We are concerned about the potential impact of these changes on patient access and safety. While we will always aim to provide care during our normal opening hours, if demand exceeds what can be managed safely, there may be occasions where patients are directed to other NHS services such as NHS 111 or local urgent care services. We sincerely hope this will be rare and only used as a last resort to maintain patient safety.

If You Have Concerns About These Changes

The GP contract is determined nationally by the government. If you would like to raise concerns about how these changes may affect access to GP services in your community, you may wish to contact your local Member of Parliament.

Charlotte Nichols MP – Warrington North

Sarah Hall MP – Warrington South

You can also find your MP using your postcode at the Houses of Parliament.

Thank you for your understanding and continued support of the practice during these changes.
Yours sincerely,
Dr Kiki Lam & Dr Lucy Hyland

GP Partners, Padgate Medical Centre