Date published: 3 February, 2025
Date last updated: 3 February, 2025
Digital, General practice, GP online services

Step-by-step guide to improving general practice website online journeys

Section 1: Overview

The purpose of this guidance and who it’s aimed at

Highly usable and accessible online journeys for patients via general practice (GP) websites and online consultation tools are a critical part of modern general practice.

This guide is for those responsible for planning, leading and maintaining GP website improvement work within practices, primary care networks (PCNs), GP federations, integrated care boards (ICBs) and other organisations.

This guidance will help you with:

  • understanding the elements of an improvement plan and the information you need to collect
  • benchmarking the usability of current online patient journeys
  • making a plan for improvement
  • delivering and maintaining that improvement

This guidance was prepared by NHS England’s Primary and Community Transformation and Improvement team as part of the national General Practice Improvement Programme.

It’s based on learnings from research into improvement projects across England undertaken at different scales by practices, PCNs, GP Federations, ICBs and NHS regions.

If you have any questions or would like to send feedback, please get in touch: england.pctgpip@nhs.net.

Benefits for general practices of highly usable and accessible online journeys

Online journeys via GP websites and apps are a key ‘front door’ to healthcare for patients alongside telephone and face-to-face contact. 61% of patients used their GP website in 2023.

Highly usable and accessible online journeys via GP websites are a vital part of a modern general practice model. High quality online journeys enable some patient contacts to move online (usually away from telephone contact) where these requests can be handled in different ways, delivering multiple benefits to patients and practices, including:

  • relieving the 8am phone rush by moving some contact online
  • relieving telephone volume pressures
  • supporting structured information gathering to understand clinical need at the point of contact (via access to online consultation tools) to facilitate effective care navigation and better align capacity with need equitably and safely.
  • reducing practice admin burden through use of digital ‘self-serve’ options, for example repeat prescription ordering or registering new patients
  • increasing digital inclusion, particularly for patients with lower digital confidence, lower literacy, who use English as an additional language and those using accessibility software and tools
  • increasing use of self-referral by patients; reducing practice burden

Getting help and key resources

Practices and PCNs can get ‘hands on’ support from skilled facilitators to help with:

  • planning, improving and maintaining online journeys via GP websites
  • integrating effectively with online consultation tools and the NHS App as part of the General Practice Improvement Programme (GPIP)

The following resources make improvement easier and quicker and are used in the step-by-step guidance that follows.

There are additional resources from GPIP which cover:

If you have any questions, would like to see some examples of good practice on GP websites or need help, please get in touch: england.pctgpip@nhs.net

Overview: four stages of GP website improvement

An improvement plan usually includes four stages: planning, improving and maintaining, with key tasks to be completed in stage.

Stage 1: Plan

  1. Leadership and initial goal setting
  2. Information gathering
  3. Identifying skills and expertise
  4. Benchmark your existing website
  5. Creating your plan for improvement

Stage 2: Improve content

  1. Understanding usable and accessible content
  2. How and who will create and test written content?
  3. Improve key pages first
  4. Review and reduce the number of other webpages

Stage 3: Migrate template

  1. Comparing and choosing a GP website template
  2. Purchasing a new GP website template and services
  3. Migrating to a new website

Stage 4: Maintain

  1. Nominated role, with the right skills to maintain content
  2. Create process to review, update and upload content
  3. Create process to access and review data

How long will this take?

Most practices who have been through this process underestimate how long it takes. The process should be seen as continual improvement and maintenance rather than a one-off task.

You can do each stage in turn and delegate some of the tasks to other parties.

It will become part of the day to day running of the practice and the skills will become embedded in the team.

In the improvement projects studied in research the fastest improvement was achieved in two weeks, the longest was two years.

On average practices take 12-18 weeks to plan, reduce written content, migrate to a new template and go-live with a new website.

Section 2: Improving online journeys step-by-step guide

Stage 1: Plan

The outcome of this phase is to develop your improvement plan and decide whether to improve your existing GP website or to migrate to a new template.

A key part of this planning is to work out which tasks the team have the skills to do themselves and where a practice or PCN needs to seek support from other parties (ICBs, suppliers etc.). Improvement projects are more likely to succeed when the right support and skills are in place.

Key tasks:

  1. Leadership and initial goal setting
  2. Information gathering
  3. Identifying skills and expertise
  4. Benchmarking the existing website(s)
  5. Creating your plan for improvement

Task 1.1: Leadership and initial goal setting

A critical success factor is having both clinical and administrative ‘buy in’ for improving online patient journeys and providing support and leadership to the project.

These co-leaders also need to agree on initial goals to ensure they are aligned. This usually involves agreeing:

  • this is a priority project
  • they agree initial goal(s) and the outcome they want to achieve, for example to “move to a new website with better access journeys for our patients”
  • they will both commit the necessary time / duration to achieve the agreed goal(s)

As part of the planning phase the projects leads will define their goals more tightly and recommit to delivering the outcome and how they will measure it.

Task 1.2: Information gathering 

Information to gather:

  • identify the current cost and contract end date for your current GP website (and any penalties for early ending of the contract)
  • ask your ICB if they have plans to audit GP websites in their area using the NHS England ‘GP website benchmark and improve tool’
  • ask your ICB if they offer or plan to offer improvement support and incentives to practices or PCNs to improve online access / GP websites
  • ask your PCN if improving GP websites together is a goal they would like to achieve, for example by negotiating a better deal with web suppliers, creating standard content for all practices websites or having one shared staff member to create, upload and check content for accessibility
  • ask if your ICB if you could participate in a National General Practice Improvement Programme (GPIP) support offer – which provides ‘hands on’ facilitator support for improvement. Your improvement could focus on improving online access and care navigation via your GP website and online consultation tool
  • ask your existing website supplier (and others) what support they can provide to:
    • audit your website using the NHS England ‘GP website benchmark and improve tool’
    • help you write and check new written content
    • help you upload and check written content and images for accessibility
    • help to maintain, review and update content across a year

Task 1.3: Identifying skills and expertise 

Delivering highly usable and accessible online journeys for patients requires many different skills and digital expertise.

It’s important to understand:

  • which skills are needed on an ongoing basis to improve and sustain the improvement. Practices or PCNs may want to invest in training for these skills
  • which skills are needed infrequently as part of occasional improvement tasks which could be annual or every few years. It may not benefit Practices or PCNs to invest in these skills, but to look for external support from PCN, GP Federation, ICS teams or service providers

The information below describes four types of skills needed for GP website improvement projects and how often they are likely to be needed.

Skill 1: Written content creation skills

These are core skills needed for improvement on an ongoing basis. They are used for improving online journeys and many other patient communications.

Skill 2: Website content formatting, uploading and maintenance skills

These are technical skills – and can be provided by website suppliers:

  • formatting images
  • uploading content
  • written content structure and formatting for accessibility
  • image alt-text for accessibility
  • periodic review
  • analytics/data

Skill 3: Benchmarking user journeys

This is likely to be done occasionally and can be provided by website suppliers and ICBs:

  • understanding of the ‘GP website Benchmark and improve tool’
  • experience of using the tool
  • understanding how to transform the findings into an improvement plan

Skill 4: Planning and migrating to a new website (template):

This is likely to be undertaken every 2-4 years and can be provided by website suppliers:

  • research and comparing website template and supplier options and support packages
  • buying or commissioning websites:
    • negotiating a good price
    • understanding the process for launching a website
    • managing the review of content across stakeholders
    • understanding responsibilities and who does what
    • planning skills for managing an action list with the supplier

Task 1.4: Benchmark your existing website

Many practices, PCNs and ICBs benchmark patient user journeys as part of their information gathering phase to help understand which elements of their website need improving. This is repeated after improvement to check it has been successful.

The NHS England GP website ‘benchmark and improve’ tool was developed to measure the usability of GP websites without having to conduct costly user testing with patients.  

If you have decided to move to a new GP website template, you may decide to skip this initial benchmark and simply test the new website template once you have added the written content and pages.

You can use the ‘benchmark and improve’ tool to: 

  1. create a checklist of improvements needed
  2. identify which elements for improvement are usually the responsibility of the website supplier (usually the web template and key accessibility elements) and which parts are the responsibility of the practice (usually written content and images)
  3. benchmark a website before and after changes are made to measure the improvement
  4. compare the usability of two or more websites (from the same supplier or different suppliers)

There are three ways a practice or PCN can benchmark their website(s):

  1. Ask your ICB if they have plans to benchmark practices in their area.
  2. Ask your website supplier if they will audit your current site using the NHS England ‘GP website benchmark and improve tool’.
  3. Undertake your own benchmarking. This can take some time to learn, especially for a one-off benchmark and there is training and support available to help you. We would recommend considering whether its quicker and cheaper to use one of the alternative options.

If you have any questions about the Benchmark and improve tool or would like training to use the tool, please get in touch: england.pctgpip@nhs.net.

About the benchmark tool

The tool has 50 evidence-based criteria, these are elements that support patients in completing 7 core tasks on a GP website. Criteria also support website elements important to practice managers and there’s an editable section for ICBs and PCNs to add additional requirements.  

A website can meet each criterion well, adequately or inadequately.  

There is no ‘pass mark’, ideally all criteria should be met well. We would strongly recommend improving criteria that are met inadequately as a priority as these are likely to present major roadblocks to patients.

Using the tool is a manual process. It can take around 2 hours to benchmark one website. The process becomes quicker the more an individual uses the tool, so we recommend one individual is trained in benchmarking multiple websites. It’s possible for someone experienced in using the benchmark tool to audit 4 websites from the same template in 45 minutes.

Task 1.5: Creating your plan for improvement

Once you have agreed your initial goals, considered the skills and expertise you need, completed your information gathering and initial benchmarking you are ready to create your plan for improvement. This could be a plan for a single practice, group of practices in a PCN or at a larger scale.

Practices and PCNs on the National General Practice Improvement Programme receive ‘hands on’ support from facilitators to help them consider the information gathered, improvement options and to create a plan.

Questions your plan should answer:

  1. Who is leading the project from clinical and admin perspectives and how are the responsibilities for this improvement project divided?
  2. Confirm your goals and how you will measure success, for example “to make sure the (new) website has no inadequate criteria when tested using the NHS England GP website benchmark and improve tool”.
  3. What are the results of the benchmark tool telling you?
  4. Will you improve your existing website or move to a newer template from your current or a different supplier?
  5. What skills and digital expertise will you need – and will you train people in the team or will you use other expert help from within the ICB or suppliers to help with key tasks.
  6. Will you improve with a group of practices in the PCN or individually?
  7. How much time will you realistically have to work on this each week?
  8. Who will review and sign off written content (does this apply to all or some pages)?
  9. What are the key tasks and milestones along the way? The findings from the GP website benchmark and improve tool will help you define areas for improvement and actions required to make the improvement.
  10. How much will it cost? You will need to speak to GP website suppliers for a range of costs and to also consider the cost of practice staff time.
  11. Who can we ask for help if we get stuck?
  12. Measurement; how will we know we have achieved our goal?

Stage 2: Improve written content and remove images

The outcome of this phase is to ensure there is someone with the right skills to create, upload and maintain website content. This might be someone in the practice, PCN or the website supplier.

We recommend focusing on improving key pages first. Moving to a new website is a good prompt for this ‘content housekeeping’, but often practices under-estimate the time it will take which delays the website going live.

Waiting for the website to be ‘finished’ creates additional work as this requires maintaining and updating the old and new websites. It’s easier to launch the new website with the key pages then add additional content as part of the ongoing maintenance process.

Images have a major impact on accessibility of user journeys and should only be used if there is a real user need. The NHS Digital service manual has guidance on use of images.

Key tasks:

  • Understanding what highly usable and accessible content looks like.
  • Nominating and training a role or person to create, review and upload content or delegating this to the supplier.
  • Improving key pages first.
  • Reducing the number of pages and removing non-essential images.

Task 2.1: Understanding usable and accessible content 

Written content on websites is one of the main factors determining the usability and accessibility of a website.

You will need to be able to recognise when content is or is not highly usable (and be able to improve it).

Highly usable and accessible content should:

Meet patient needs

  • Patients want to know what to do and how to do it. Avoid explaining why or how a process exists.
  • Use language that patients would use.

Be well structured

  • Group the written content into different sections.
  • Have clear headings. This helps patients who struggle to read a lot of text. Meaningful headings help patients with access needs to navigate web pages.

Have clear links

  • Keep the words on the link short.
  • Start with a verb, for example: “Request an appointment” or “Register with the surgery”.
  • Links should describe where they’re taking the user. Do not use link text such as “click here” or anything that does not make sense on its own.

Be concise and clear

  • Use plain English and aim for a reading age of 9 to 11 years old.
  • Check all additional text with the Hemmingway Editor.
  • Be concise. Use short words, short sentences and short paragraphs.
  • Avoid jargon. Check words are understandable to patient by using the A to Z of NHS health writing.

Task 2.2: How and who will create and test written content? 

The capability to create, edit and upload highly usable and accessible written content is a critical capability in improving online journeys.

Creating good written content requires understanding of the rules and guidance on writing for NHS websites. These include:

There are three ways practices or PCNs can access this critical capability:

  1. Ask a GP website supplier to provide content creation, review and testing as a service to the practice or PCN.
  2. Train a member of the practice or PCN to create, review and test new content.
  3. Train a member of the PCN or ask the ICB to create, review and test ‘shared’ content all practices can use.

Task 2.3: Improve key pages first

The main users of a GP website are patients. They come to the website to complete tasks. Their top tasks define the website’s core purpose. Supporting this purpose and those tasks is the website’s main goal.

Our research showed that these were the top tasks for patients on a GP website:

  • make or request an appointment (including via an online consultation form)
  • change or cancel an appointment
  • get a repeat prescription
  • get a sick note for work
  • get test results
  • register with/join the practice
  • get the practice phone number
  • find out the practice opening times
  • find the practice address

To improve these key tasks, you should focus on improving the four most important webpages first. These are listed below. All sites should have these as separate pages.

We recommend using the following NHS England written content templates which meet NHS content guide and reading age. These can be adapted with local information where needed:

If you are adapting written content templates, it is important to check the changes you make to the written content templates. As a minimum you should use the Hemingway editor check the readability and reading age of any content you add. Website suppliers can often provide practices and PCNs with support with written content service. ICBs often have content writers in their digital or locality or communications teams.

We have also created and tested content templates for other common pages on GP websites:

Task 2.4: Review and reduce the number of other webpages

By reducing the number of pages on your website and number of words on each page, you will make the ongoing content creation and maintenance challenge smaller.

You can do this as part of an improvement process, or you can focus on the key pages first and do this review of other webpages as a separate project.

  • Start with your website analytics to look at pages that have had the least number of people visiting them. Consider removing or cutting down pages that are viewed the least. Your website supplier can help you access data about page views.
  • Ask your website supplier if they can:
    • review your pages
    • suggest pages to retire or reduce
    • rationalise the content for you
  • Consider linking to national content on nhs.uk where it is maintained centrally rather than maintaining content on your own website. For example, about symptoms, medical conditions and urgent health information (e.g. COVID-19).
  • With every section or page of content, think whether it’s important to patients. See if it can be reduced or combined with another page.
  • Add timestamps to your pages to show when the content was last reviewed and updated.
  • Use auto removal settings to remove or retire pages or schedule regular checks to review the freshness of content.

Stage 3: Move to a latest GP website template

The outcome of this stage is to:

  • review GP website template options available
  • identify which options meet practice and patient needs
  • migrate to this new template and to go-live

There are three tasks to undertake:

  1. Comparing GP website templates and services offered by suppliers.
  2. Purchasing a new website.
  3. Migrating to a new template.

Task 3.1: Comparing and choosing a GP website template

The first question you should ask is whether the practice is on the latest version website template from your existing supplier. A call to your existing supplier should be able to answer this question.

NHS England recommends practices use the most up to date GP website templates as these are the most accessible and usable.

NHS England also recommends using a GP website template that is well aligned with national guidance Creating a highly usable and accessible GP website for patients.

You can compare the most widely used templates from different suppliers by viewing GP website templates comparison with NHS England guidance. This provides information about how well aligned different GP website templates are with national guidance, including accessibility requirements.

Task 3.2: Purchasing a new GP website template and services

If you’re planning to run a procurement exercise, write a tender document or review suppliers you might find our guidance ‘If you’re using a tender process’ helpful.

Speak to your ICB. Many ICBs have reviewed suppliers, some have local shortlists of approved suppliers / templates and some offer practices expertise and financial support to move to latest version GP website templates and create highly usable and accessible online journeys.

Things to consider are:

  • how well aligned the GP website is to national guidance (Creating highly usable and accessible GP websites for patients)
  • the accessibility of the GP website template. Ask suppliers if they have independent testing or audit of their templates accessibility and ask for an accessibility statement. The GP website templates comparison with NHS England guidance includes a section on accessibility
  • services the supplier can offer; for example, helping draft or review written content, uploading content and checking for accessibility, annual audit of the site using the NHS England ‘GP website benchmark and improve tool
  • the support and functionality a supplier provides for:
    • creating and uploading content
    • usability and accessibility prompts and tips in the screen that’s used to manage the website (also known as the content management system)
    • encouragement to use the NHS England written content templates for key pages
    • training and ongoing support after migration and ‘go live’ with the new or improved website
  • how a supplier supports practices to make sure the content on their website is up to date:
    • does the supplier check content regularly?
    • are there published and updated dates on webpages?
    • does the content management system support updating all links across the website with one action, for example when a practice changes their online consultation tool?
  • key functions that support shared working with your PCN, for example individual practice websites on a common digital platform so you can see and compare data
  • cost of the service
  • length of contract. Given the rapid pace of change and improvement we would recommend considering 12 or 24 month contracts or longer ones with break clauses

Task 3.3: Migrating to a new website

Once you have selected and agreed to purchase a new website template from a new or existing supplier you will need to plan the migration of information into the new website template.

Most suppliers have well established migration plans, with checklists of things a practice needs to do and usually provide a named contact to support the migration.

We recommend aiming to have as few pages on your new website and as few words on each page as possible. You can either:

  • review and reduce the amount of written content, images and webpages before you migrate to a new website
  • or start afresh with the NHS recommended written content templates that suppliers should provide on your website by default

This will make the migration easier and quicker and reduce your ongoing maintenance challenge. Suppliers can often help with this task.

In the improvement programmes studied in the research, migrating websites took a minimum of 2 weeks and a maximum of 2 years. For planning purposes, it would be reasonable to assume 6-8 weeks for the migration process to happen and for the site to go live.

Practices not having reviewed, reduced or created and updated website content was the most common reason for delay in completing the migration and going live.

Stage 4: Maintain

The outcome of this stage is to have a nominated role or supplier with the right skills and the right processes in place to make sure your website stays highly usable and accessible for patients.

There are three key tasks:

  1. Nominate a practice or PCN role with the right skills or a contract in place with a website supplier to provide this service.
  2. Put in place a process to review, update and upload content.
  3. Access to and measurement of data.

Task 4.1: Nominated role, with the right skills to maintain content

You will need to ensure there is a practice or PCN staff role nominated with responsibility for reviewing and updating written content. This staff role should have received appropriate training.

You will need to ensure there is a practice or PCN staff role nominated with responsibility for uploading and checking the accessibility of uploaded content.

One or both functions could be provided as a service by a GP website supplier.

Task 4.2: Process to review, update and upload content

You will need to create a process to regularly review and update content, this could include:

  • reviewing key pages every 6 months, all other content annually. This could be done on a rolling basis, with a certain percentage of content checked each month
  • immediate review and updating if the practice changes online consultation tool, phone system or if there are changes to a practice process
  • using the NHS England ‘GP website benchmark and improve tool’ to check the website every 12-18 months
  • considering whether to update to a latest GP website template every couple of years
  • maintaining skills in the team if there are staff members who write, review and update website content

Task 4.3: Process to access and review data

Website suppliers should provide you with analytics and data reports. These reports should contain basic statistical data on how your patients use your website. The main data they should provide is:

  • number of visitors and number of unique visitors
  • most used pages
  • homepage links used
  • search results
  • visitor demographics (if available), like age, gender, location
  • what devices people are using to access your site (split between mobile, tablet and desktop)

This data is important so you can see how your site is performing and where to focus your efforts.

Practices should request access to their website analytics from their supplier. Some suppliers will provide practices with bespoke analytics dashboards which are often easier to understand.

Analytics also provides useful information when it’s time to decide about website content, for example, when new items have been added and you want to check they are being used and working as intended. 

Written by: Dominic Vallely, Dr. Minal Bakhai, Louise Croney, Emmy Graham

With thanks to: All of the teams in Birmingham and Solihull ICB, Black Country ICB, Cheshire and Merseyside ICB, Greater Manchester ICB and Stockport, NHS South-East Region, Southport and Formby PCN, South West Accelerator team, Sunderland GP Federation, Surrey Heartlands ICB

This guidance was prepared by NHS England’s Primary and Community Transformation Team as part of the national General Practice Improvement Programme.

If you have any questions would like to send feedback, please get in touch: england.pctgpip@nhs.net.

Publication reference: PRN01429

Date published: 3 February, 2025
Date last updated: 3 February, 2025