Guidance – BMA Message: Important news about 1 October contract changes
The BMA have circulated this message in advance of the 1 October 2025 contract changes.
At the meeting last week, GPCE (the BMA GP’s committee England) voted to re-enter dispute with the Government, DHSC (Department of Health and Social Care) and NHS England from 1 October on the grounds of grave patient safety, workforce wellbeing, and – as data controllers with legal obligations – data breach concerns for practices.
Please read this message very carefully.
We are all concerned about the contract changes coming into effect on 1 October. Specifically, those changes that relate to making online consultations tools available to patients throughout core hours and switching on access to update record via GP Connect for other NHS providers.
We dispute that it is safe to proceed with these contractual changes at the present time.
To ensure compliance with new contractual requirements in the 25/26 contract agreement in March 2025, and to avoid receiving remedial or breach notices from ICBs (integrated care boards), practices must currently ensure the following from 1 October:
- that they have an online consultation tool, which is available to registered patients throughout core hours (8am – 6.30pm) in order to request non urgent and routine appointments
- that GP Connect (Update Record) functionality is enabled.
These contract changes only apply to practices that have agreed to the changes or received a notice from their ICB notifying them that the changes will automatically apply to their GMS/PMS contract.
Background to disputing these changes
GPC England voted to accept the 2025/26 contract back in March, conditional on what the negotiating parties had mutually agreed. The availability of online consultation tools throughout core hours was formally confirmed in writing by the Government, DHSC (Department of Health and Social Care) and NHS England back in February, but was subject to:
‘The necessary safeguards in place to avoid urgent clinical requests erroneously submitted online. Guidance will be displayed on practice websites and reflected in the wording of the Patient Charter’.
‘Avoid’, here, means to prevent the patient from erroneously submitting an urgent request. The agreement was that safeguards would be put in place to stop urgent requests from being submitted online. Guidance would be in addition to those safeguards as guidance alone cannot avoid urgent requests being submitted erroneously and would be unsafe. Agreed for these changes to be implemented from the 1 October was reached only on the condition that necessary safeguards would be developed and then put in place.
The necessary safeguards which DHSC and NHSE committed to putting in place before bringing in the contractual changes, have still not been put in place, which is why we dispute that this contractual change is safe for patients and practice staff.
We have tried to work with NHSE and DHSC officials since March but, despite making every effort, the agreement on ‘necessary safeguards’ for the 1 October contract changes has been reneged on. Those organisations now show a wilful refusal to accept any responsibility for ensuring that necessary safeguards are in place to protect patients and practice staff from harm. This includes enablement of GP Connect: Update Record functionality, which, as things stand, will not be accompanied by indemnity cover for GPs (the data controllers) for data breaches by other NHS providers who do not comply with legal obligations related to data processing.
You will all be acutely aware that this situation is compounded by recommendations in the NHS 10 Year Health Plan’s recommendations to proceed with novel GP contract structures. There have been no assurances that the GMS (General Medical Services) contract – the vehicle that, when fully resourced, enables continuity of care in community settings delivered by a family GP – will be protected and preserved into the future.
The Government now has one last chance, at next week’s Labour Party conference, to avoid all this by giving explicit assurances that either:
- it will ensure that the ‘necessary safeguards’ to avoid patients erroneously submitting urgent online consultation requests will be implemented before 1 October, or
- ICBs will be explicitly instructed not to issue remedial or breach notices until the necessary safeguard have been put in place.
If the Government does not provide the assurance we need, we will have no option but to re-enter dispute on 1 October.
It is therefore in both patients’ and practices’ best interests for NHS England and DHSC officials to secure the safeguards that the Secretary of State has recognised which are:
- functionality that prevents patients erroneously submitting urgent requests via online consultation tools
- safe functionality for GP Connect: Update Record and
- practice indemnity cover for GP Connect related data breaches by other NHS providers.
The Government must also ensure a focus on GMS renewal over and above NHS 10 Year Health Plan ambitions around novel contracts, which will only dilute GMS. Without this, the SoS has also reneged on his written commitments to the profession in March and August.
Ahead of next week’s contract change, GPC England has prepared additional guidance for all GPs and GP registrars. There is also more coming next week. Please note that contract changes only come into effect once a practice has received a contract variation notice from their ICB and after at least 14 days’ notice. Contract variations occur after the notice period regardless of whether a practice signs the notice or not.
What does going into dispute with the Government mean?
The BMA’s GPCE would be establishing a trade dispute with the Government on behalf of practices in England. This would confirm that the profession does not agree with changes being implemented (contractual) and proposed (NHS 10 Year Health Plan).
However, to ensure there is no risk of remedial or breach notices, even though a trade dispute is established, practices must still comply with their new contractual obligations from 1st October 2025. However, the trade dispute would establish that the profession does not agree with the change – on grounds of risk to patient and staff safety – and is ‘working under protest’.
The next potential escalatory step includes balloting affected BMA members on whether they would be prepared to undertake proposed industrial action(s) – non-contract breach or otherwise.
The LMC’s advice on 1 October contract changes is still available and can be accessed here.
29/09/2025