Purpose
The 2026/27 GP Contract includes a requirement that patients identified by the practice as clinically urgent must be dealt with on the same day. For integrated care boards (ICBs), this supports a Medium Term Planning Framework target.
This document sets out how practices should use national category appointment slots and the approach to measuring the Medium Term Planning Framework target.
Clinically urgent same day
We do not currently measure or publish a ‘same day appointments for clinically urgent patients’ metric. Moving forward, practices should record appointments for all patients they deem to be clinically urgent using appointment slots mapped to the General Consultation Acute national category within General Practice Appointments Data (GPAD). This applies to patients presenting by telephone, walk-in or online.
It is for the GP practice to determine which patients are clinically urgent, in the same way they do now. The decision about whether a patient is clinically urgent does not need to be a retrospective clinical judgement, but rather a decision made based on the patient’s presenting complaint.
Performance against this target will be calculated in the following way each calendar month, via the ‘general consultation acute’ GPAD category:
Numerator = number of appointments mapped to a national category of ‘general consultation acute’ which took place on the same day (time from booking to appointment)
Denominator = total number of appointments mapped to a national category of ‘general consultation acute’
Alignment with existing appointment recording requirements
Practice should continue to use the standard set of GP appointment categories which were introduced in March 2021, which included a range of activities which could be covered by the General Consultation Acute category. Moving forward, as above practices should ensure that they use this category for clinically urgent patients.
‘Non-clinically urgent’ within 7 and 14 days
As set out in the 2026/27 GP contract changes letter, to support understanding of demand in general practice, we will collect data on the percentage of ‘non-clinically urgent’ appointments taking place within 7 and 14 days and encourage practices to use this data to improve services for patients. Practices should be aware that for the purposes of this we are intending to use the national categories of General Consultation Routine and Care Home Visit. At this point we are not intending to include Unplanned Clinical Activity, Walk-in, and Home Visit categories given these can be either urgent or routine, and each comprises less than 1% of total activity.
Why action is necessary
A recent review of appointment books shows that alignment with the national categories has drifted significantly from 2021 guidance. For example, appointment book slots that are used for clinically urgent activity but which are mapped to non-urgent national categories.
General Practice Appointment Data (GPAD) data shows wide variation in the volumes of activity mapped to the different categories. Some variation is expected but practices with high volumes of ‘inconsistent mapping’ or unexpectedly low volumes of general consultation (acute) activity are unlikely to accurately represent the activity flowing through those practices.
Ensuring that all appointments are recorded accurately and aligned with national categories helps ensure a true picture of GP appointment activity helping practices to understand their own pressure points and improvement opportunities.
Action for practices
- Prioritise a review of appointment book slots for clinically urgent activity, ensuring that the slot is mapped in line with the national category guidance.
- Review all other appointment book slots to check alignment between slot mapping and the national category guidance. There may be some clinically urgent activity captured within these slots without the practice being aware.
- Review appointment book slot mapping against the proposed categories to be used for ‘non-clinically urgent’
- Review individual GPAD dashboards which will help in identifying any potential issues unique to the practice.
Monitoring
Data on the proportion of clinically urgent appointments undertaken the same day will be made publicly available through a change to the existing General Practice Appointments Data (GPAD) collection.
ICBs will monitor and support practices to achieve the requirement.
GP appointments data hub
A central repository for GP appointments data (GPAD) containing the national publication, information on accessing your data through local and national dashboards, user guidance, and policies. The hub has been created to support general practices, primary care networks and integrated care boards in improving the quality of their data so that it more accurately reflects the services they provide. The GP Appointments Data Dashboard – National Category mapping guide is also available on this hub.
Dashboards
GPAD dashboards have been developed to support practices, PCNs and ICBs. Details of each dashboard and how to access are accessible via these links:
- General practice GPAD dashboard
- Primary care network GPAD dashboard
- Integrated care board GPAD dashboard
For GPAD dashboard queries contact: contact the NHS England Contact Centre: enquiries@nhsdigital.nhs.uk, 0300 303 5035.
Any queries regarding the published GPAD, contact: data: england.accesstogeneralpractice@nhs.net
Any queries regarding the GP Contract, contact: england.gpcontracts@nhs.net
Publication reference: PRN02409