Version 1.0, 19 January 2023

This guidance is part of the Working in a digitally transformed NHS section of the Good practice guidelines for GP electronic patient records.

e-business is short for ‘electronic business’. As an overarching term, it encompasses all forms of using digital, information, and communication technologies to support and optimise business processes – from preparation to implementation.

General practice information technology (IT) systems are an example of e-business applications, and sit at the heart of primary care, facilitating and recording millions of interactions with patients each week.  In challenging environments, IT must improve patients’ and providers’ experiences of available services, in turn enhancing the quality of care provided. IT services must also enable practices to realise efficiency benefits and reduce the administrative burden.

NHS England supports practices through current initiatives, and significant investments, to develop IT functionality and interoperability.

The NHS Long Term Plan committed, through an implementation framework, to a number of digital obligations in the GP contract. The GPIT Futures (GPITF) framework programme is critical to enabling the continued delivery of clinical IT systems that meet the needs of general practice in England. The programme responds to the evolving needs of patients whilst underpinning integration across care pathways.

Digital first primary care

Face-to-face patient/GP interactions have traditionally been the way healthcare is delivered in primary care. General practice is, however, now seeing a growth in digital first primary care, where the first contact a patient has with their GP practice is via a digital channel such as an app or via the website. This might be an asynchronous consultation through the NHS App, online appointment booking, etc. Services must, however, remain available through the traditional routes as well, including by ‘phone and walk-in.

The NHS Long Term Plan sets out a vision to offer digital first primary care to all patients in England by 2023/24. New, digital-first primary care is proving convenient and popular with staff and patients alike.

There is also emerging evidence that digital GP models may help expand the GP workforce participation rate by offering flexible working opportunities to part-time GPs.

 The NHS will deliver on this commitment to digital first primary care through three approaches:

  • First | The NHS will create a new framework for digital suppliers to offer their platforms to primary care networks on standard NHS terms. The GP IT Futures Tech Innovation Framework supports system suppliers as they work to deliver cloud-based innovative technological solutions into the GP marketplace.
  • Second | There will be ongoing assurance that new ‘digital first’ practices are safe and create benefit to the whole NHS. The assurance needs to be transparent and shareable to the end-user organisations.  Current out-of-area arrangements will be reviewed, and GP payment formulae will be adjusted to ensure fair funding without favouring one type of GP provider over another.
  • Third | GP regulation and terms and conditions will be reviewed, with the aim of better supporting the return to practice and increased participation rates by GPs wanting to work in this way.

General practice patient facing services

General practice has led the move away from paper to digital systems in healthcare. Direct practice investment in technology has led to better online tools, appointment, consultation, and workload management systems.

The NHS App, managed by NHS Digital, was launched on 31st December 2018. Figures from NHS Digital tell us that 3 years after launching it had more than 22 million users and was one of the UK’s most downloaded free iPhone apps in 2021.

Since the COVID Pass was introduced to the App in May 2021, there have been over 18 million new registrations. NHS Digital strives for continuous improvement for the NHS App.  Improvements and additions will depend on feedback from users and funding. They have also produced a roadmap showing the planned development of NHS digital services.  

General practice  routinely uses technology to offer a wide range of patient facing services. These range from transactional services like repeat prescriptions and appointment booking to clinically focussed services like online consultations and secure access to the GP clinical record. You will find other articles in this series about these services listed at the end of this document.

Improvements in digital technology within general practice can also now allow:

  • fit notes (eMED3) to be produced without needing a physical signature, which can be sent to the patient electronically
  • forms of electronic triage after data has been submitted electronically (either by the patient or a member of the practice team)
  • improved telephony services using cloud-based providers

General practice business functions

Since 2020, as a result of the COVID-19 pandemic, the health and care sector has undergone significant transformation, achieving levels of digitisation that would previously have taken years.

Through the NHS England Transformation Directorate, general practice has seen significant digital investment in business functions that don’t have direct interaction with the patients but do have a significant impact on general patient care.  Examples include:

  • through standardisation of processes, such as the introduction of SNOMED-CT, a single structured clinical vocabulary for use in an electronic health record across all care settings in England
  • time saved through easier access via online consultation systems like eConsult which can be available through the NHS App or the practice website, online appointment booking and cancelling
  • better interoperability of different systems, such as the current shared care record initiative
  • improved reporting functions through the calculating quality reporting service (CQRS)
  • improved collection of data from GP systems for use in planning and research through the forthcoming general practice data for planning and research (GPDPR) – when pooled together, data held in general practice patient records supplies a detailed picture of the nation’s health; and offers the most reliable evidence on which to base decisions on healthcare planning and delivery
  • paperless electronic invoicing to help support the NHS net zero strategy
  • electronic payments for services not covered by the GP contract such as travel vaccinations, HGV medicals, etc.
  • attendance at locality meetings moving to Microsoft (MS) Teams
  • FutureNHS
  • QRisk calculator
  • electronic discharge letters

The What Good Looks Like programme builds on good practice and provides clear guidance for health and care leaders on how to digitise, connect and transform services safely and securely.

The following links supply further information on other key digital enablers in general practice:

There are a number of other articles in this series that provide guidance on education, training and developing opportunities.  These are listed in the ‘Related GPG content’ below.

Patient facing services provided by general practice

Education and training


Other helpful resources