Following the Covid pandemic we have witnessed a massive backlog of care. 

GPC England advises practices to move to a waiting list system for appointments as demand currently greatly outstrips capacity. 
 
There has been pressure on GP practices to offer an immediate assessment and management of all patient problems regardless of actual clinical urgency. This is impossible to maintain, is not required by the GMS/PMS contract, and may be counter-productive in terms of patient expectations and experience. There is little evidence this approach correlates with patient satisfaction levels. 

Practices are obliged by their GMS contract to provide for the reasonable needs of their patients and for the assessment of urgent problems arising in their patients in their practice area. Emergency or urgent problems can be directed to emergency departments, 999, or 111. Patients that can wait should, following assessment, be placed on the waiting list if safe capacity for appointments is exceeded for the day. 
 
General practices should have waiting lists that are based on clinical need. This is the approach that exists in secondary care, even if it means that patients with non-urgent problems may wait many months for an appointment. This only formalises the already existing informal waiting lists for patients that cannot get an appointment at a convenient time. This will allow GPs to focus their resources on those with the greatest need, to deliver safe high-quality care. 
 
A patient’s clinical condition may well change whilst on the waiting list. It is important to develop and communicate safety netting processes to patients, so they can seek medical attention if needed should their condition deteriorates. You may consider reviewing the urgency at this point if you have capacity at your practice.