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, conducted by the University of Oxford, University of Manchester and Queen Mary, University of London, explored how online consultation and digital triage systems shape decisions about what kind of care patients get and when. The study offers useful insights for general practice teams in the midst of implementing the recent policy changes – including insights from three general practice teams who implemented and adapted digital consultation and triage systems, and a visual guide co-developed with patients to help patients understand how their general practice works and how to get the care they need.

Our findings  

Our study puts a spotlight on the work done by general practice teams, and also patients, to make online access and digital triage technologies run smoothly. These and other digital tools play a big role nowadays in the way care is organised and delivered. Online forms, messaging systems, and remote consultations are changing how patients and staff communicate. They can make care more flexible and convenient, but we also observed how they can create distance and barriers to care — for example, when patients fill in forms at home instead of speaking directly with a receptionist, who often reassures patients or or helps them clarify their request. Digital systems can unintentionally make it harder for some patients to get care, which can widen inequalities in access to care. 

We found that the successful use of digital tools is a team effort. Doctors, receptions staff, and patients use digital tools to communicate with each other about the type of care and appointments patients need. Whether this communication runs smoothly, is not only influenced by the design and ease of digital tools. It is also influenced by practice protocols and policies that describe how digital tools should be used, when they should be used, and by whom. Staff also learnt when patients cannot use digital tools or when digital communication is not working well, instead offering different contact options to share information about patient care and appointments between patients, receptionists, doctors and other clinical staff.

We observed that doctors, reception staff, and patients do a lot of quiet, behind-the-scenes, ‘invisible’ work to make sure that communication runs smoothly and patients get the care they need. Reception staff, for example, were often seen to raise concerns with doctors about patients who they saw struggling to get care. Recognising this hidden work helps general practice teams to plan for it, develop better practice policies, support and train their staff accordingly, and keep access to care safe and fair for all.

The new policy requirement to keep online access systems open during core hours will require some general practice teams to change the way they work. This includes learning about the impact of these policy changes on the way patients contact their general practice – for example, when do patients send requests for care, via which contact route, has the number of care requests changed, or the type of requests? General practice teams might consequently decide to update practice policies and digital protocols to better organise and process different types of care requests; adapt staff roles to manage changes in care requests and support patients who might be underserved in the new system; and educate patients about the appropriate use of different contact options in their practice.

Helping Patients Navigate GP Access and triage 

Based on our study 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. In line with the newly launched “You and Your General Practice” (YYGP) patient charter, our guide aims to support general practice teams to communicate mutual expectations between patients and the GP practice regarding appointment booking.

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.