The clocks have changed. Has your GP practice?

Twice a year, the UK changes its clocks. In March, we lose an hour. In October, we get it back.

Your smartphone sorts itself out. Your microwave probably doesn’t.

Your GP practice systems? They’re somewhere in between.

Most modern clinical systems should handle the transition between Greenwich Mean Time (GMT) and British Summer Time (BST) without anyone noticing.

But general practice now runs on far more than a single clinical system.

Online consultation platforms. SMS reminders. Cloud telephony. Appointment booking rules. Automated recalls. Self-check-in kiosks. Scheduled searches and reports.

All quietly doing their jobs, often without anyone giving them a second thought.

Until something doesn’t work as expected.

The challenge isn’t necessarily that these systems can’t cope with the clocks changing. Most should. It’s that practices increasingly depend on multiple systems, managed by different suppliers, with settings configured at different times by different people.

And just because SystmOne or EMIS may know what time it is doesn’t mean every connected process is working as intended.

A few minutes of checking twice a year might prevent considerably more work later.

Here are five areas worth reviewing whenever the clocks change.

1. Online consultations: the one with contractual consequences

Let’s start with the important one.

Under the GP contract in England, practices must make online consultation tools available throughout core hours, 8am to 6.30pm, Monday to Friday (excluding bank holidays), for non-urgent appointment requests, medication queries and administrative requests.

The 2026/27 GP contract changes also require practices not to cap the number of online consultation requests that patients can submit during core hours.

This doesn’t mean unlimited appointments, or that every request needs an immediate clinical response. Appropriate clinical prioritisation, safeguards and response arrangements remain essential.

But it does mean that a scheduling error preventing patients from submitting permitted requests during core hours could become a contractual access problem.

And this is where the type of online consultation platform you use matters.

Some providers offer automated scheduling that can manage opening and closing times, including adjustments for BST and GMT.

Other platforms or configurations may require practices to set their own schedules, manually switch functionality on or off, or manage particular request types separately.

Even where the supplier provides automated scheduling, a practice may have additional locally configured rules or external automations.

So here’s the question:

If someone originally configured your online consultation platform to open at 8am and close at 6.30pm, how confident are you that those settings will still behave correctly when the clocks change?

If schedules use UK local time with proper time-zone handling, they should adjust automatically.

But if they rely on a fixed UTC offset, an external automation or a manual switching process, the change between GMT and BST could create unexpected behaviour.

In March, a platform might open or close an hour later than intended. In October, it could do so an hour earlier. The actual effect depends on the configuration.

And for practices using manual processes, there’s another risk. The person responsible may be on leave, may have changed roles or may simply not realise an adjustment is needed.

I recall one Monday morning, marvelling how at 0805 we still had not had a single online request come in. The team were not worried, but I knew something was amiss. Lo and behold, a quick check showed our online platform had not switched on, and no requests were coming through – the sudden onslaught of phone calls was a stark reminder.

An hour later, the fix was done, as the person who could do the fix was not due in that day till 9 am, but that loaded up our day for a challenging couple of hours with the backlog that still gives me nightmares.

What to check:

Does your supplier automatically adjust opening and closing schedules for BST and GMT?
Are opening hours automated, manually configured or dependent on someone switching the platform on and off?
Do locally configured schedules use UK local time or a fixed UTC offset?
Are different request types controlled by separate time settings?
Does the patient-facing experience match your intended and contractually required access arrangements?

Practical action: Don’t just check the time displayed in the administrator dashboard. Check how the system actually controls patient access.

If your practice relies on manual switching, consider whether the process is reliable, has sufficient cover during absences and could be replaced with a properly configured automated schedule.

The safest setup isn’t necessarily the one with the most automation. It’s the one where the practice understands the process, knows who owns it and can be confident patients can access the service when they should.

2. SMS reminders and automated messages: one hour can make a difference

Automated messaging is brilliant when it works.

Appointment reminders, vaccination invitations, questionnaires and recall messages save practices considerable administrative time.

Nobody wants reception manually sending hundreds of flu vaccination invitations when technology can handle the task.

But there’s a difference between scheduling something for 9am UK local time and 9am UTC.

During winter, those times match. During British Summer Time, they’re an hour apart.

Good scheduling software understands this and adjusts automatically. Less sophisticated configurations, particularly custom automations or integrations, may not.

An SMS campaign arriving an hour earlier than expected isn’t necessarily a major problem.

But consider hundreds of vaccination invitations arriving just as your telephone lines open, generating calls that could have been spread throughout the day.

Or a campaign going out just as the practice closes, when nobody is available to answer the resulting queries.

What to check:

Appointment reminder schedules.
Bulk SMS campaigns and vaccination invitations.
Automated recalls and questionnaire messages.
Scheduled searches, reports and data transfers.
Custom workflows using third-party automation platforms.

If you’re unsure whether a system uses UTC or UK local time, ask the supplier.

And don’t just change every scheduled time by an hour. If the system already adjusts correctly, you could introduce the very problem you’re trying to prevent.

3. Online appointment booking: when exactly do your slots become available?

Patients quickly learn when their practice releases online appointments.

Some will be checking the NHS App at the advertised release time, hoping to find something suitable.

Now imagine those appointments become available an hour earlier than intended.

By the time patients arrive at the expected time, some may already have gone.

Alternatively, appointments might not appear until an hour later, prompting patients to assume there are none available.

Neither helps patient confidence, and both can shift unnecessary enquiries towards reception.

This is particularly relevant to practices using scheduled slot releases, appointment embargoes or third-party booking platforms.

What to check:

Scheduled appointment release times.
Embargo and advance-booking rules.
Rules releasing slots a fixed number of hours before an appointment.
Third-party booking and self-referral tools.
Whether patient-facing information reflects what actually happens.

You don’t need to rebuild your appointment book.

Simply check whether the next scheduled release happens at the advertised local time.

4. Telephony, call-backs and the forgotten systems

Cloud telephony has transformed how many practices handle incoming calls.

Automatic routing, call-back queues, opening-hour announcements and overflow arrangements all have genuine benefits.

But they also introduce more time-dependent settings.

Your main telephony provider may handle BST and GMT perfectly. The question is whether any locally configured rules or connected services behave as expected.

Imagine your phones switching to an out-of-hours message an hour early.

Or a call-back queue continuing to offer call-backs beyond the point when staff are available to complete them.

These are potential configuration risks, not problems every practice should expect.

What to check:

Opening, closing and lunchtime call-routing rules.
Call-back availability and cut-off times.
Out-of-hours messages and NHS 111 signposting.
Additional telephone services and third-party integrations.
Self-check-in kiosks and waiting room screens.

And don’t forget the building itself.

Access controls, security alarms and heating schedules may also have time-dependent settings.

Your GP appointment book might be correct while the building is still convinced it’s Sunday.

5. The hour that disappears — or happens twice

Here’s where it gets slightly geeky.

When the clocks go forward in March, UK local time jumps from 1am to 2am. The intervening hour doesn’t exist.

When they go back in October, the hour between 1am and 2am happens twice.

A little like a Star Trek time-loop episode, except without the convenient option of resetting the warp core.

For most routine general practice activity, this won’t matter.

But it can become relevant when reviewing events occurring overnight by OOH services.

Consider an out-of-hours consultation, an electronic prescription, an NHS 111 interaction or an incident being investigated retrospectively.

In October, two events displayed as occurring at 01:30 might actually have happened an hour apart.

In March, an entire hour disappears from the local clock.

Well-designed systems can use UTC timestamps or time-zone information to preserve the sequence of events. But what clinicians see on screen may be a local-time representation.

What to check:

Whether an audit trail displays UK local time or UTC.
Whether apparently duplicated or out-of-sequence timestamps reflect the clock change.
Whether different integrated systems display the same event consistently.
Whether your supplier can clarify the underlying time standard when an investigation depends on it.

This isn’t a reason to audit every overnight consultation.

It’s a reminder that if chronology is clinically or legally important, you need to understand which clock you’re looking at.

Your twice-yearly GP practice clock-change checklist

You don’t need an emergency meeting, another 20-page standard operating procedure or an NHS working group to review this.

A short, targeted check by your practice manager, digital lead or nominated administrator should identify whether anything needs further investigation.

Before or immediately after the March and October clock changes:

Online consultations are available throughout the required core hours.
Online consultation scheduling, including supplier automation or manual switching, accounts for BST/GMT changes.
Patient-facing opening hours and urgent-care signposting are correct.
SMS reminders, recalls and scheduled campaigns run at their intended local times.
Online booking slots are released when patients expect them.
Telephone routing and call-back windows work correctly.
Kiosks, waiting room screens and relevant building timers show the correct time.
Custom automations with fixed schedules have appropriate time-zone settings.
Anyone investigating an overnight event understands the potential timestamp differences.

Not every item will apply to every practice. And some checks are better completed by reviewing settings or supplier assurance than by testing an entire service.

The aim is assurance, not generating another task mountain.

The bigger issue isn’t the clocks. It’s who owns the automation.

This is perhaps the most important part.

General practice is increasingly reliant on automated processes.

And that’s largely a good thing.

But every additional platform introduces another dependency.

Who checks that an automated recall actually ran?

Who notices when messages stop arriving?

Who knows which system controls the telephone schedule?

The practice manager might reasonably assume the supplier manages it.

The supplier might assume the practice configured it correctly.

The clinician assumes the patient received the message.

Meanwhile, the automation quietly carries on doing whatever it was originally told to do.

This is where a little digital housekeeping could make a genuine difference.

Keep a simple register of your important scheduled systems. Record what they do, who owns them, whether their timing is controlled by the supplier or the practice, and how someone would know if they failed.

A shared spreadsheet may be enough for routine operational workflows. More clinically significant systems should sit within the practice’s existing governance and clinical safety arrangements.

Build the March and October clock changes into that review process.

Not every system needs testing twice a year. And supplier-managed systems shouldn’t require practices to duplicate unnecessary technical assurance.

But critical patient-facing workflows deserve someone who knows they’re working.

One hour shouldn’t create an extra hour of work

The clocks changing shouldn’t be a major operational event for general practice.

Modern technology ought to manage most of the transition quietly and reliably.

But there’s a difference between assuming something works and knowing it works.

With more of general practice relying on online consultations, automated communications, digital booking and integrated platforms, we need to understand which systems depend on timing — and who is responsible for them.

Automation is brilliant when it saves us work. Less brilliant when nobody notices it has stopped working.

And perhaps that’s the real lesson from the clocks changing.

We don’t need to check everything. We just need to know which things matter.

So here’s my question: which automated system in your practice would cause the most disruption if it started running an hour out of sync — and who would notice first?

I’d be interested to hear what other practices have discovered.

For more practical guides on making technology work better in general practice, visit eGPlearning or subscribe to the eGPlearning YouTube channel.

Verified references

When do the clocks change? — GOV.UK, updated 24 November 2025. .
Changes to the GP Contract in 2025/26 — NHS England, 2025.
Supplementary information to support changes to the 2026/27 GP contract — NHS England, 2026.
Online consultations: frequently asked questions and support resources — NHS England, published 29 September 2025, updated 14 January 2026. Explains expectations for online access, urgent-care safeguards and exceptional circumstances for switching off services.
GP contract changes England 2026/27 — British Medical Association, 2026. Provides the profession’s account of the contractual changes covering access, online consultation limits and response arrangements.