Digital First Primary Care

Digital technology is transforming how patients and health professionals interact. As a result, NHS England is supporting primary care to move towards a digital first approach, where patients can easily access the advice, support and treatment they need using digital and online tools. ​These tools need to be integrated to provide a streamlined experience for patients, and quickly and easily direct them to the right digital or in-person service. ​

In practical terms, this means patients should be able to use online tools to access all primary care services, such as receiving advice, booking and cancelling appointments, having a consultation with a healthcare professional, receiving a referral and obtaining a prescription.

NHS England is developing a programme of work to support practices and primary care networks (PCNs)  to move towards providing Digital First services. For more information please contact

Online consultations

GP practices are increasingly offering more online access to services, including the option to have an online consultation. Online consultation systems allow patients to contact their GP practice without having to wait on the phone or take time out to come into the practice, and they form an important part of Digital First Primary Care. Online consultations enable patients to ask questions, report symptoms and upload photos. The practice then looks at the request and responds within a stated timeframe, connecting the patient to the right person, service or support. Currently, most practices who have implemented online consultations use a questionnaire-based system, with their own staff then looking at requests from patients and delivering the service in response. However, there are also opportunities to manage online consultations at a larger scale, for example across primary care networks or via a hub model. Some practices are also offering patients the option to have an appointment with a clinician via video (a video consultation).

Research has been commissioned to understand the impact of online consultations on general practice. However, evidence to date and case study findings show that where online consultations are implemented as part of a comprehensive primary care service, they enhance the experience of care for patients and support general practice in managing time and workloads, improving both access and sustainability.

A simplified patient journey

Digital requirements in the GP contract

The NHS Long Term Plan, published in January 2019, commits to every patient having the right to be offered digital-first primary care by 2023/24.

The five-year framework for GP contract reform published to implement The NHS Long Term Plan, introduced a bold set of commitments related to digital services in general practice, agreed by NHS England and NHS Improvement and the British Medical Association (BMA).

These commitments are being introduced gradually every year through the GP contract since 2019-2020, and by now all GP practices should, among other new requirements:

  • have an online presence, such as a website, and an GP profile page, both of which they keep up to date
  • no longer use fax machines for NHS communications
  • offer all patients online access to their GP medical record
  • offer and promote to their patients, and those acting on their behalf, access to an online consultation tool, which enables patients to contact the practice online
  • offer and promote video consultations to their patients as an option for receiving care where that would be appropriate.

More recently, many of these patient-facing digital requirements are presented as part of a ‘core digital offer’ – see annex C of the GP contract letter published on 21 January 2021.

All requirements are introduced into law and can be found in the records and information section of The NHS (General Medical Services Contracts) Regulations, with an equivalent for personal medical services contracts. Related guidance to practices for some of these requirements is on our website and on our FutureNHS pages (please register for a FutureNHS account).