About a third of GP consultations in England are by telephone. Telephone consultations remain an important part of NHS general practice. They can improve convenience and access for some patients, but they also remove visual cues that GPs often rely on during face-to-face care. This can make clear communication particularly important, especially when there is uncertainty about how a patient’s illness may develop.
Safety-netting advice can include information about warning signs to look out for, how long symptoms might last, when to contact a GP again, when to call NHS 111, or when to seek urgent or emergency care. It is a key part of managing clinical risk in general practice and helping patients make informed decisions after a consultation.
Detailed findings
The study analysed 96 recorded GP telephone consultations from seven practices in South West England. It found that safety-netting advice was delivered in 60.4% of consultations and applied to 43.4% of problems discussed. Most advice was initiated by the GP, and much of it was given during treatment planning. The study also found that safety-netting advice was more likely to be given by younger GPs. The reasons for this are unclear, but it may reflect differences in training, consultation style, or approaches to managing risk during consultations.
However, the advice was not always recorded in the clinical notes. Among consultations where medical notes were available, delivered safety-netting advice was documented in approximately two-thirds of cases. Written advice, such as sending a post-consultation text message, was rarely used. It was provided in only four of the 96 consultations, all by text message.
Patients correctly remembered that safety-netting advice had been given in around two-thirds of consultations where it was delivered. This suggests that, although GPs are frequently giving safety-netting advice by telephone, there may be missed opportunities to make this advice clearer, more consistent, and easier for patients to remember.
The delivery rate of safety-netting advice in telephone consultations appears broadly comparable with previous research on face-to-face consultations. In an earlier study of face-to-face GP consultations by the authors, safety-netting advice was delivered in 64.5% of consultations and applied to 46.3% of problems. Documentation was slightly higher in the telephone study than in the previous face-to-face study, although it was still inconsistent. Written advice was rare in both studies.
The authors highlight that better documentation and greater use of written advice could help support patient understanding and safety in remote care. Digital tools, including clinical prompts or AI tools, may also have a future role in helping GPs record and share safety-netting advice, although these approaches would need careful evaluation.
The study used real recorded telephone consultations, allowing researchers to examine what was actually said during routine care rather than relying only on medical records. However, the authors note that the study was conducted in seven practices in one region, and that patients who consented to take part may not fully represent all patients using GP telephone consultations.
Dr Peter Edwards, NIHR Doctoral Research Fellow and GP at the Centre for Academic Primary Care, University of Bristol, said:
“Advice about when to seek further help is one of the main ways GPs help patients know what to do if their symptoms change or worsen. This can help patients feel more confident about what to do after the consultation.
“Our study suggests that this advice is given in about two-thirds of telephone consultations, but it is not always recorded in the notes, given in writing, or remembered by patients.
“We also found that younger GPs were more likely to give this advice, although further research is needed to understand why. This may reflect differences in training, consultation habits, or how clinicians manage uncertainty during remote consultations.
“Telephone consulting remains an important part of general practice, so we need to make sure patients leave these consultations with clear, practical information about when and how to seek further help. We know patients prefer written advice, but this is time-consuming for GPs who are already overstretched. Better use of digital tools could help, but they need to be developed and evaluated with patient safety at the centre.”
The research was supported by the National Institute for Health and Care Research (NIHR) and Bristol, North Somerset and South Gloucestershire Integrated Care Board (ICB).
Paper: Safety-netting communication during telephone consultations: an observational study using recorded consultations. Peter J Edwards et al. Published in British Journal of General Practice. June 2026.