Navigating GP access and triage: Resources to support patients

GP access and triage today 

Since October this year, every GP practice in England has operated under two new national policies designed to make it easier for patients to contact their surgery and understand what to expect from their care.  

The new policies speak to the ongoing challenges that came with the rapid expansion and implementation of remote access and care during the Covid-19 pandemic and beyond. One of the key changes from this time was the introduction of online access and triage systems designed to structure decision-making about who gets what kind of care. This has been the focus of the ModCons project, research completed by the Nuffield Department of Primary Care Health Sciences and Said Business School at the University of Oxford in collaboration with the University of Manchester and Queen Mary University of London. The ModCons study aimed to understand how, when and by whom decisions are made about the type of care patients are offered. 

The first of the two new policies introduced this autumn is the “always-on” online access requirement which is part of the 2025/26 NHS England GP contract. This requirement means that all practices must keep their online consultation systems open during core hours (8 am – 6:30 pm, Monday to Friday). Whilst the aim is to make access to general practice fairer and more flexible, this shift has caused significant concerns around workload, effective triage and patient safety, especially as practices balance online demand with existing pressures.  

The second policy is the launch of the “You and Your General Practice” (YYGP) patient charter, which every practice must have published on its website by the start of October this year. The charter sets out mutual expectations between patients and practices — for example, how and when patients can expect to receive responses, and how they should use different access routes. 

These changes to GP access — the “always-on” online system and the new You and Your General Practice charter — come at an important time. Many practices are already balancing high demand, staff shortages, and increasing use of digital tools. For patients, getting the right kind of help, at the right time, can still feel complicated.  

By focusing on the everyday decision making in general practice, the ModCons study explored how choices are made about the format, urgency and staffing of patient care.  

Our findings  

We found that access and decision-making is really a team effort. Doctors, reception staff, and patients all play a part in deciding what kind of appointments are offered and how requests are handled. These decisions are influenced by practice policies, the systems used, and the wider NHS guidance. 

Digital technology now plays a big role in this process. Through what we call digital mediation, online forms, messaging systems, and remote consultations are changing how patients and staff communicate. These tools can make care more flexible and convenient, but they can also create distance — for example, when patients fill in forms at home instead of speaking directly to a receptionist. Understanding how different people use and experience these tools helps practices make them work better for everyone. 

We also explored access inequalities — how digital systems can unintentionally make it harder for some patients to get care. To design fair systems, practices need to think about people who find online tools difficult or don’t have good internet access. 

Finally, we looked at the invisible work that keeps everything running — the quiet, behind-the-scenes efforts by staff and patients to make sure care happens smoothly. Recognising this hidden work helps practices plan better, support staff, and keep access safe and fair for all. 

Helping Patients Navigate GP Access and triage 

As an outcome of our findings, we created a new visual guide to help patients understand how to book an appointment and get the right kind of care from their GP practice. It’s designed to make today’s often complex systems — especially those using triage or online requests — easier to follow. 

Any GP practice in the UK can use this resource. It is ideal for practices that want to explain their triage process clearly and consistently, whether that’s through their website, waiting room screens, or patient leaflets. 

The guide can be downloaded and adapted — for example, by adding the practice’s contact details or specific terminology. It can then be uploaded directly to the practice website or shared. 

This resource has been co-designed with NHS clinicians and patients as part of the ModCons study. Our goal is to support both patients and staff to navigate care more confidently and effectively.