Urgent care

John Sharvill

doi:10.3399/bjgp26X746325

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Urgent care
Hugh Matthews

Published on: 24 August 2026

Published on: (24 August 2026)
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Urgent care
Hugh Matthews, GP, Kent
As usual, John Sharvill makes some pertinent points.¹ At our practice, we still rely primarily on patients phoning or coming to the surgery for in-person appointments, and long-standing skilled receptionists helping to direct them to see the right person in the right time frame. However, given the push to unlimited online access, I can see why many practices are moving to total online triage, and I don't know how long we will be able to hold out. At the core of this is a fundamental dishonesty from politicians and NHS England regarding the amount of primary care that can reasonably be provided given the current funding and workforce. The promise from the previous Health Secretary that everyone can have as many online consultations as they like, for anything, however trivial, without any limitation is pushing general practice to a transactional model which favours those who may not have the greatest health needs. On top of this, there seems to be a reliance on technology and it being the saviour of the NHS, which is not warranted by current evidence. While many developments in clinical software have been useful, it takes far longer to sign off an electronic prescription than it did when we had a pile of green paper. Likewise, we now have to spend tens of thousands of pounds to employ staff to look at incoming documents to work out the ones that we really need to see because it is impractical for us to view all of these ourselves online.

So the digital...
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As usual, John Sharvill makes some pertinent points.¹ At our practice, we still rely primarily on patients phoning or coming to the surgery for in-person appointments, and long-standing skilled receptionists helping to direct them to see the right person in the right time frame. However, given the push to unlimited online access, I can see why many practices are moving to total online triage, and I don't know how long we will be able to hold out. At the core of this is a fundamental dishonesty from politicians and NHS England regarding the amount of primary care that can reasonably be provided given the current funding and workforce. The promise from the previous Health Secretary that everyone can have as many online consultations as they like, for anything, however trivial, without any limitation is pushing general practice to a transactional model which favours those who may not have the greatest health needs. On top of this, there seems to be a reliance on technology and it being the saviour of the NHS, which is not warranted by current evidence. While many developments in clinical software have been useful, it takes far longer to sign off an electronic prescription than it did when we had a pile of green paper. Likewise, we now have to spend tens of thousands of pounds to employ staff to look at incoming documents to work out the ones that we really need to see because it is impractical for us to view all of these ourselves online.

So the digital shift in the NHS so far has probably increased the work of the most scarce and expensive resource - GPs. I would also note that discharge summaries from hospitals have stretched from one or two pages of handwritten or typed information to often eight pages stored in a data centre, without any increase in the amount of useful information transmitted. Certainly, where I practise, we have had numerous IT failures this year, and because everything is now stored off-site, we face a significant issue when the infrastructure cannot cope with what is being asked of it. There are no easy answers, but perhaps a system built around the needs of clinicians and patients might not be too much to ask for?

Reference

1. Sharvill J. Urgent care. Br J Gen Pract 2026; 76 (769): 348. DOI: 10.3399/bjgp26X746325.
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Competing Interests: None declared.