The National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) (Amendment) Regulations 2026
Amended NHS GP contracts to remove online consultation limits and mandate electronic registration and screening data sharing.
These Regulations amend the standard contracts for General Medical Services and Personal Medical Services in England to modify how patients interact with GP practices and pharmacies.
The instrument directs GP contractors to stop limiting online consultation requests during core hours, requires them to provide next-day responses for non-urgent matters, and mandates cooperation with the national Lung Cancer Screening Programme.
It applies to all NHS GP contractors and NHS England, establishing new duties for data sharing, staff survey participation, and the use of digital registration tools.
Arguments For
The regulations state that contractors must not limit the number of online consultation requests that can be made during core hours, which the document frames as part of improving patient access.
Proponents within the document's framing suggest that requiring doctors to consult patients on their choice of pharmacist ensures patients maintain control over where their medications are dispensed.
The order asserts that mandate-based data collection for the Lung Cancer Screening Programme is necessary for the national programme to detect and diagnose lung cancer effectively.
The legislation indicates that standardising referral pathways (such as 'Advice and Guidance' models) will ensure clinicians comply with NHS England’s determined routes for specialist care.
Arguments Against
Legal scholars might question the administrative burden placed on GP practices by requiring the manual entry of paper registration forms into online systems.
Affected parties, specifically general practitioners, may raised concerns regarding the removal of caps on online consultation tools, citing potential workload pressures during core hours.
Critics may argue that the requirement for practices to monitor a specific clinical email address at least once daily adds to the cumulative regulatory compliance duties for small primary care teams.
Ambiguity exists regarding what constitutes "reasonable" cooperation with NHS England for performance reviews, potentially leading to disputes over the scope of operational interference.
Citation, commencement and extent
- -(1) These Regulations may be cited as the National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) (Amendment) Regulations 2026.
- (2) These Regulations come into force on 15th June 2026.
- (3) These Regulations extend to England and Wales.
This section establishes the official name of the regulations and sets the date they become Law as 15 June 2026.
While the jurisdiction extends to England and Wales, the underlying clinical powers cited apply specifically to NHS services in England.
Schedule 1
Amendments to the National Health Service (General Medical Services Contracts) Regulations 2015
Patient choice: pharmaceutical services
- In regulation 58- (a) for the heading substitute 'Patient choice: pharmaceutical services'; (b) after paragraph (2), insert-
'(2A) The contractor must, where the patient has a nominated dispenser, consult the patient, or the patient's authorised person, as to their choice of dispenser in respect of each order for drugs, medicines or appliances made by a prescriber under regulation 56.';
- (c) for paragraph (4) substitute-
'(4) A contractor must not seek to persuade a patient, or a patient's authorised person, to nominate a dispenser recommended by the prescriber or the contractor.
(5) The contractor must direct the patient, or the patient's authorised person, to the relevant information made available by NHS England about all chemists who are available in the patient's chosen area and who are able to provide the required service where-
- (a) a patient does not have a nominated dispenser;
- (b) a patient, or a patient's authorised person, asks the contractor to recommend a chemist whom the patient or the patient's authorised person might nominate as the patient's dispenser; or
- (c) the contractor refers a patient to a pharmaceutical service.'.
This paragraph requires GP practices to consult patients on their preferred pharmacy each time a prescription is issued.
It prohibits doctors from pressuring patients to use a specific pharmacy and mandates that practices provide a neutral list of all available local chemists if a patient asks for a recommendation or hasn't selected one.
Online consultation tool
- In regulation 71ZD (patient online services: provision of an online consultation tool), for paragraph (2) substitute-
'(2) An 'online consultation tool' is an online facility provided using appropriate software which satisfies the condition in paragraph (2A) and through which a patient, or an appropriate person acting on behalf of a person to whom paragraph (4) applies, may make-
- (a) a request for advice or information related to the patient's health, or
- (b) a clinical or administrative request.
(2A) The condition in this paragraph is that the online facility does not limit the number of requests using the online consultation tool that can be made during core hours or during any period of time within core hours.'.
This section redefines online consultation tools to ensure they allow for both clinical and administrative requests.
It prohibits practices from setting a maximum limit on the number of requests patients can submit digitally during their standard operating hours.
Contact with the practice
- In Schedule 3 (other contractual terms), paragraph 4 (contact with the practice)-
- (b) after sub-paragraph (2), insert-
'(2A) The contractor must not ask a patient to contact the practice on another day.';
- (d) after sub-paragraph (3), insert-
'(3A) For matters which the contractor has identified as not clinically urgent, the appropriate response must be provided before the end of the next working day after contact.'.
Practices are prohibited from telling patients to call back on a different day to make a request.
For non-urgent health or administrative matters, the practice is now required to provide a response by the end of the next working day.
Information relating to the Lung Cancer Screening Programme
74L. -(1) A contractor must allow the extraction by NHS England, or by persons authorised by NHS England, of data reasonably required for the purpose of the Lung Cancer Screening Programme... (3) In this regulation, 'Lung Cancer Screening Programme' means the national programme arranged by NHS England of lung health checks for the purpose of detecting and diagnosing lung cancer...
This provision requires GP practices to allow NHS England to automatically extract patient data from their clinical records for the national lung cancer screening initiative. Practices must cooperate with these data extractions to help identify patients who qualify for lung health checks.
Referral pathways
11C. -(1) NHS England may notify the contractor of referral pathways that apply to the referral of patients for other services under the Act. (2) The contractor must, where clinically appropriate, comply with any relevant referral pathways notified under paragraph (1), prior to referring a patient for services under the Act.
This section grants NHS England the power to set specific procedures that GPs must follow before referring a patient to a specialist.
If a pathway like 'Advice and Guidance' (consulting a specialist for management advice before a formal referral) is notified, the GP must follow it unless it is not clinically appropriate.
GP registration
- In Schedule 3, in paragraph 18 (application for inclusion in a list of patients), after sub-paragraph (4) insert-
'(4A) Where the contractor receives an application by the method referred to in sub-paragraph (3)(a), they must submit the information provided in the application via the online registration service... except where the contractor's computerised clinical system does not facilitate interconnectivity...'.
GP practices that receive paper-based applications for new patient registrations are now required to manually enter that information into the NHS online registration service. This requirement is waived only if the practice's current computer system is technically unable to connect to the national service.
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