A healthcare expert has cautioned that the new GP contract taking effect on April 1 could have serious implications for patients - particularly women. The Government maintains it will enhance access to primary care, with nearly £500 million being injected to boost capacity.

However, journalist and author Penny Parkes fears the reforms could make it considerably more difficult for patients to obtain a referral from their doctor. A referral occurs when you are directed to a specialist in a particular field for expert care.

Speaking on her Instagram account, she acknowledged the measure will probably cut outpatient waiting lists. Nevertheless, she also expressed concern about its potential consequences.

• Practitioner says omeprazole may cause 'two problems' for anyone on it for reflux


• Couple stranded in Philippines with serious injuries after holiday crash

She said: "So, the new GP contract comes into force on the 1st of April. And from that point onwards, your GP won't be able to refer you in the way that they can now. In fact, everything is about to change.

"They're going to be relying a lot more heavily on something called advice and guidance, which is basically them reaching out to specialists, back and forth email chain, obviously confidentially, getting advice from the consultant and then passing that advice or medication or testing protocols on to you the patient.

"Now, there's a couple of problems with that and obviously the motivation for this is to reduce outpatient waiting lists, which it will of course do, but whether it will actually help the patients is a slightly different question. And realistically, whilst it might reduce the outpatient waiting lists, I imagine it's going to make it even harder to get a GP appointment.

"One of the things that concerns me most, particularly for complex patients, is that any implicit bias or assumptions that have been made in that original GP consultation will be passed on through the email chain to the consultant. So you won't as the patient have the chance to sort of make your case to present your symptoms. You will tell your GP what's going on, they will formulate a query to the consultant, the consultant will come back and the GP will hopefully implement the advice that has been given.

"So advocating for yourself is going to become increasingly important, but also making clear if you are essentially looking for a referral and now know that advice and guidance is the pathway. If there is something particular you want your GP to include in that, reach out to the consultant. It would really be a good idea to have that in the forefront of your mind when you're having that conversation and maybe even sort of write it down and take it in with you and be very clear."

The Government maintains the reforms will deliver 'better access to appointments and general practice services'. It's supported by a £485 million funding increase - the second consecutive year featuring a real-terms rise in GP funding.

Additionally, almost £300 million of current funding will be ringfenced and redirected into GP surgeries as part of proposals to recruit extra GPs, or expand sessions carried out by GPs already employed at the practice. It is anticipated this will amount to a boost equivalent to 1,600 full-time GPs.

The new contract also mandates that all patients with urgent requirements have access to a same-day GP appointment. Health Secretary Wes Streeting said: "Through this government's investment and modernisation, we're fixing the front door to the NHS.

"We're giving practices the flexibility to hire more GPs and backing them with extra funding to do so. As a result, many more patients with urgent needs will be able to get an appointment the day they contact their practice. Taken together, our changes will help patients stay healthy and out of hospital, whether it's jabs for children, screening for lung cancer, weight loss support or continuity of care - we're backing our GPs to build a healthier nation."

However, Ms Parkes expressed her concerns about the potential negative impact on women, stating: "I am a little bit concerned about how this is going to affect complex patients and I'm also very concerned about how it's going to affect female patients who traditionally have their symptoms more widely dismissed.

"It just feels like it's one further step of removal from the patient to the consultant who might actually have the answers but can only respond to the query they are sent.

"NHS England have gone to great lengths to reassure GPs that the referral under Jess's rule will still stand. That is the rule whereby if you present more than three times with the same set of undifferentiated, that's really important, undifferentiated symptoms, that means they aren't attached to a diagnosis, then referrals can still go ahead, but as always, the limitations with Jess's rule are the wrong diagnosis also counts as a diagnosis in this case and you would need to advocate even more strongly for yourself."