Online Consultations in English General Practice

Trading names vs legal entities: NHS England records suppliers by legal entity name, which can differ from the product brand. Key mappings: Continuum Health Limited = Anima (same company, Companies House 12205370); Airmid = TPP (TPP's patient-facing app); Silicon Practice = Footfall; Evergreen Health Solutions = EvergreenLife.

Interpretation caution: These rates are per month. Klinik's 248 per 1,000/month extrapolates to ~3,000 per 1,000 per year — roughly 3 OC submissions per registered patient per year. Differences between suppliers may partly reflect how each system defines a "submission" (e.g. whether admin requests, repeat prescriptions, or automated messages count). They may also reflect genuine differences in patient engagement driven by product design and ease of use.

Context: The smallest practices (<2,000 patients, n=91) have a median of just 2 OC submissions per month and a median utilisation rate of 2.9 per 1,000. This likely reflects that small practices have little need for digital triage — with a small list, reception staff and GPs know their patients personally and can manage access through direct relationships. The “digital front door” solves a problem of scale that these practices simply don’t have. The strong size–utilisation gradient across all bands suggests OC adoption is driven as much by practice scale as by any product or policy factor.

It's a curve, not a line. The Pearson correlation between % aged 65+ and OC rate is essentially zero (r = +0.01), but the quintile breakdown reveals a clear inverted-U pattern. The highest OC use is in Q3 — practices with around 16–20% over-65s, close to the England average. These “average age” practices appear to have the right mix of digitally-confident working-age patients and chronic-disease workload to drive online contact.

The oldest lists use OC the least. Q5 practices (where more than a quarter of patients are over 65) have a median rate of just 54.6 per 1,000 — about 30% below Q3 and the lowest of any quintile. This fits the intuition that older patients are less likely to use online routes, and that practices with elderly lists keep phone and face-to-face channels more prominent. Despite the October 2025 mandate requiring OC systems to be open during core hours, demand-side digital exclusion remains a real constraint for older populations.

Younger lists also use OC less than Q3, but only modestly. Q1 practices (typically university, inner-city or young-family lists) sit a little below Q3, possibly because younger, healthier populations consult less in absolute terms regardless of channel. Wonford Green Surgery in Exeter is a good example: with ~10% over-65s it's firmly in Q1, and its 53.8 per 1,000 rate is below the Q1 median of 77.

Caveat: age alone is a weak predictor. Deprivation, urban/rural setting, list size and supplier choice all swamp it — a multivariable model would be needed to disentangle them properly. The flat means (vs more variable medians) reflect a long tail of high-volume practices in every quintile.

Correlation, not causation: Differences between suppliers almost certainly reflect the characteristics of practices that choose each supplier (urban/rural, list size, deprivation, staffing) rather than the OC platform itself. Klinik and EvergreenLife practices, for example, have notably higher rates of patients contacting via website — likely because these platforms are designed around a “total triage” model that routes most contacts through the website.

This does not mean OC makes patients unhappy. The negative correlation likely reflects confounding: larger urban practices in more deprived areas tend to have both higher OC volumes (because they need digital triage to manage demand) and lower satisfaction (because of pressure on access). The OC system is a response to the problem, not the cause. Supplier-level clustering is also visible — Klinik and Anima practices cluster at higher utilisation but lower satisfaction, while Footfall practices cluster at lower utilisation and higher satisfaction.

Small practices running as total triage are very rare. Across the whole of England, only 9 practices with fewer than 4,000 patients achieved 300+ submissions per 1,000 patients in February 2026, and not a single practice under 2,000 patients did so. These outliers are worth naming.

Interpretation — two very different strategies. EvergreenLife (askmyGP) and Klinik both have a third to a quarter of their practices operating at 300+ submissions per 1,000 patients per month. That is consistent with these platforms being designed as total-triage systems where patients almost always enter the practice through the OC front door, and it matches what we see in GPPS: Klinik and EvergreenLife practices report much higher rates of patients contacting the practice via the website (39% and 21% respectively, vs a 6% national average).

At the other extreme, eConsult essentially never runs at 300+/1k — only 1 of 943 sole-eConsult practices does so, and only 2 go above 200/1k. This fits the model of eConsult as a demand-management tool bolted on top of traditional phone triage rather than a complete front door, and is consistent with its historical positioning.

Accurx, TPP and Footfall sit in the middle at 6–7% of sole practices above 300/1k, suggesting they can be configured either way depending on practice preference. Anima sits slightly higher at 10%, with a long right tail reflecting its growing adoption by practices wanting a more complete digital front door. Rapid Health practices cluster tightly around 150–200/1k — a characteristic of a triage-led but not fully online model.

Caveat: this is only February 2026 and only sole-supplier practices. Multi-supplier practices are excluded to avoid ambiguity. A very high rate can also reflect local signposting (e.g. PCN-level same-day hubs routing through one practice), not just practice policy. The “300+” threshold is a pragmatic proxy for total triage, not a formal definition.

Three different rankings tell three different stories. By highest current rate, Surrey Heartlands (239/1k), Bedfordshire/Luton/Milton Keynes (214) and Lincolnshire (198) lead. By fold change since August 2024, the steepest movers are Shropshire (4.9×), Norfolk & Waveney (4.8×), Derby & Derbyshire (4.7×) and Sussex (4.5×) — all started from a low base. By proportion of practices at 300+/1k, Suffolk & North East Essex (27.8%), Lincolnshire (27.2%) and Surrey Heartlands (26.5%) are the most saturated. Mid & South Essex and the Black Country are notable movers but not the most extreme on any single measure.

Important note on bucketing. NHS England changed the schema for this dataset in December 2025. Older files use eight 2-hour buckets (00–06, 06–08, 08–10, 10–12, 12–14, 14–16, 16–18, 18–24); the newer per-date files use hourly buckets. To compare months on a like-for-like basis we collapse the newer hourly buckets back into the original 2-hour bins. So when this page says "8–10am share" it means the same thing in every month — the proportion of all submissions arriving in the two-hour 08:00–09:59 window.

Caveat: Some apparent "switches" may reflect changes in how NHS England attributes suppliers rather than genuine procurement decisions. The methodology changed in September 2025 from cumulative to current-month attribution, which may have caused some practices to appear to change supplier.

Key discovery — trading names: This audit revealed that Anima (400+ practices) reports as Continuum Health Limited (CH 12205370, Dr Shun Pang). Airmid is TPP's patient-facing app. askmyGP was acquired by EvergreenLife in November 2021 and reports as Evergreen Health Solutions. These brand/legal-entity mismatches are a significant source of confusion.

Disclaimer: This site is for information only. It is not a recommendation, ranking or endorsement of any GP practice or software supplier. Figures reflect the state of NHS published data at the time of the most recent refresh and may contain errors or omissions in the underlying source data. Nothing on this site should be interpreted as clinical, regulatory or commercial advice.

Supplier identity mapping (from Companies House & website audit):
Continuum Health Limited (CH 12205370) = Anima — same company, CEO Dr Shun Pang
Airmid = TPP's patient-facing app (airmidcares.co.uk, "TPP's app designed to support you")
Silicon Practice Ltd = Footfall
Engage Health Systems Limited = Engage Consult (first appeared Feb 2026)
Evergreen Health Solutions = EvergreenLife / askmyGP (acquired Nov 2021 by Evergreen Life)
Not yet in data: SmartConsult (~20 practices)