Choose which local action to take
GPC England is not recommending which local action(s) practices take. It is for each practice to pick and choose should they see fit. You may decide to add to your choices over the days, weeks, and months ahead.
Some of these local actions can be permanent changes – an opportunity to embrace sustainable and safe change.
We have also created template letters to help practices manage workload and limit capacity to deliver safe, high-quality care.
Limit daily patient consultations
Limit daily patient consultations per clinician to the UEMO recommended safe maximum of 25.
Divert patients to local urgent care settings once daily maximum capacity has been reached. We strongly advise consultations are offered face-to-face where you deem it to be clinically appropriate. This is both more effective and efficient for patients and clinicians – read our patients first document available here.
Serve notice on any voluntary service
Unless contractual terms can be re/negotiated with ICBs, serve notice on any voluntary or under resourced services currently undertaken that plug local commissioning gaps. Do not fill commissioning gaps, which ICBs are solely accountable for, at the expense of your business and staff. As with any contract, they must be properly resourced to ensure patients get quality care and the services are sustainable.
Enhanced services are defined as primary medical services other than essential or additional services defined in your practice contract or out-of-hours services. This page provides information about directed and local enhanced services in England.
Consider how you are engaging with the e-Referral Advice & Guidance (A&G) pathway
The 2025/26 GP contract includes welcome investment into advice and guidance. There may be cases of advice and guidance which lead to lengthy back and forth discussions with further requests for GP actions. It is perfectly acceptable in such cases to send a referral letter to the relevant specialty and not use A&G. We have provided a focus on document on the use of referral tools, and a template response to send if your referral is rejected.
Further information on proformas and referral forms in General Practice can be found in our guidance. If you encounter problems with this, we recommend contacting your LMC.
Switch off GP Connect (Update Record) functionality
This is embedded by the local ICB for the purposes of system financial savings and/or rationing (rather than the clinical benefit of your patients). You should always act in your patient’s best interests and prescribe appropriately for the clinical presentation. Some areas may have local commissioned services for this software, and if you are unsure about this, contact your LMC.