Across the UK, general practice is embracing the shift to digital-first access. Online Consultation tools, once seen as a convenient add-on, are now a contractual requirement for practices in England. But as recent reports highlight, the rapid expansion of online access also carries risk, particularly when digital front doors are left wide open without safeguards to triage what comes through.
A new Management in Practice survey of over 400 GPs and practice managers in England revealed that 67% are concerned for patient safety, with urgent and even life-threatening conditions being reported through standard online forms. Respondents cited examples ranging from chest pain and breathing difficulties to suicidal thoughts and head injuries, all logged via ‘non-urgent’ online submissions. This underscores a growing challenge for primary care: as access channels multiply, so too does the risk of digital overload. Without intelligent filtering and signposting, Online Consultation tools can quickly become the very bottleneck they were designed to remove.
The risk of standalone Online Consultation tools
From October 2025, practices in England were required to keep Online Consultation tools open during core hours as part of the GP contract 25/26. For many practices, the instinctive response might be to make a web form permanently visible on the practice website. On paper, this meets the requirement. In reality, it creates higher risk. While extended digital availability promises convenience for patients, it increases the likelihood of clinical and administrative overload when the right triage safeguards are not in place.
If patients use online forms to report symptoms that should trigger urgent clinical attention, practices are immediately placed in a high-risk scenario. As the Management in Practice report highlights, this is already happening daily in some surgeries, with “urgent requests involving unwell or feverish children” logged through non-urgent forms. In one reported case, an urgent message about a sick baby arrived late in the day and wasn’t seen until the following morning.
The issue is not with online consultation tools themselves, but with how they’re implemented. Many current systems simply present a static web form that is open to anyone, at any time, without triage. An open form invites every type of request, from medication queries to medical emergencies, into the same queue. It also attracts duplicate, incomplete or non-clinical messages that still require manual review. The result is overwhelmed inboxes, growing triage queues and clinical risk as urgent cases are buried among routine requests.
Instead of freeing up capacity, practices can find themselves firefighting demand. What should improve equity and efficiency instead compounds the pressures it was meant to relieve. The question is not whether digital access should exist, but whether it can exist safely without intelligent navigation and triage built in.
Why Online Consultation tools need intelligent triage
At its core, online consultation tools are a point of entry. But like any gateway, it must be safely managed. Patients often can’t distinguish between urgent and non-urgent issues, particularly when faced with an open text box. That’s where intelligent triage comes in. By embedding automated signposting and guided pathways into the patient journey, practices can ensure that clinical urgency is recognised early and routed appropriately.
An effective digital front door should:
- Assess patient intent before an Online Consultation tool is displayed
- Direct patients with potentially serious symptoms to emergency or urgent care services
- Allow routine requests to proceed safely through online forms
- Integrate with existing systems so practice teams can manage requests in one place
Without this structure in place, practices risk turning digital access into digital chaos, where the volume of incoming forms far exceeds clinical or administrative capacity.
Building safer Online Consultation tools with Surgery Assist
At X-on Health, we’ve long recognised that simply digitising access isn’t enough. It must be done intelligently, balancing patient convenience with clinical safety and staff wellbeing. That’s why our AI-powered care navigation assistant, Surgery Assist, embeds online consultation capability within intelligent triage, not beside it.
The key here is not to surface this Online Consultation (OC) form on your website, which could overwhelm admin teams, but instead to add a tool like Surgery Assist that can signpost patients to services better suited to their needs, with an OC form as an option for those who need to see a GP.
Before a patient reaches an online form, Surgery Assist engages them in a short, guided conversation to understand their request. Using intelligent care navigation, it can:
- Redirect up to 30% of queries to community, pharmacy or NHS App services
- Flag clinically urgent cases, prompting the patient to call or book an appointment instead of completing a non-urgent form
- Present the OC form only when appropriate, within the same chat interface for a seamless experience
- Soon support voice submission for further accessibility and inclusion
Requests then flow into the practice’s existing systems, giving teams better visibility to handle cases safely. By filtering requests upfront, practices reduce unnecessary workload, prevent unsafe submissions and maintain compliance without compromising patient access.
From compliance to confidence with Online Consultation tools
As the NHS continues its journey towards digital-first, the emphasis must shift from availability to safety and sustainability. Online consultation tools can improve access, but only when they’re part of a structured, intelligent system that helps patients reach the right care, first time.
The lessons from the Management in Practice report are clear: leaving digital front doors wide open creates risk for both patients and staff. Intelligent triage isn’t an optional extra, it’s the foundation of safe, scalable access.
With Surgery Assist, we’re helping practices move beyond simple compliance. By embedding OC functionality within intelligent navigation, we’re supporting practices to protect patient safety, manage workload effectively and prepare for the digital-first NHS envisioned in the 10-Year Health Plan.
In short, it’s not about opening more doors, it’s about opening the right ones.