Digital First Primary Care

Digital technology is transforming how patients and health professionals interact. As a result, NHS England and NHS Improvement is supporting the availability of digital and online tools so that patients can easily access the advice, support and treatment.

Digital First Primary Care is the name of a programme which supports the transformation of primary care by promoting the implementation, understanding and improvement of digital tools within general practice.

The tools can support patient access to appropriate and timely care, help practices better manage demand, and improve patient and staff experience.

Online consultation requests in general practice

The pandemic has increased the use of online consultation requests in general practice. As well as phoning or visiting a practice to request help, patients can use a secure form on their general practices website to submit requests for help and advice about their medical condition. They can be a convenient way for people to ask for medical advice, treatment for their symptoms, follow up on a previous issue or make a new request.

A clinician will respond based on each patient’s clinical needs and preference. They may, for example, offer a face-to-face appointment, make a phone call or video call to the patient, or send a simple text or online message (for example to invite the patient to come in for a blood test).

The legal definition of an online consultation system is outlined in ‘new digital and online services requirements: guidance for GP practices.’

Video consultations

Most GP surgeries, hospitals, mental health services and community care services now offer video consultations. They contact the patient with a video call to their smartphone, tablet or computer, enabling them to talk to the patient and see them.

This can save patients time as you will not need to travel for a face-to-face appointment. It can also help to prevent the spread of infection.

If a GP, doctor or healthcare professional recommends you have a video call, you will get a text, email or letter with a date and time for the appointment.

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 nhs.uk 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 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).