GPs to be mandated to see 90% of ‘clinically urgent’ patients ‘on the day’
NHS England is planning to set GPs a new target of seeing 90% of all ‘clinically urgent’ patients on the same day.
A medium-term planning document published today sets as one of its targets to ‘improve access to primary care, including reducing unwarranted variation in access’.
‘Specifically, ensure 90% of clinically urgent patients are seen on the same day,’ it adds.
According to the document, NHS England will ‘consult with the profession on this new ambition and approach’.
It said that next month it will publish a ‘model neighbourhood framework’ which will set out the ‘definitions, goals and scope of neighbourhood health’, along with ‘priority actions’ for 2026/27.
NHS England will also produce ‘model system archetypes’, which will outline different archetypes for the commissioning and provision of neighbourhood health services, including the the new contract types announced in the 10-year plan (single and multi-neighbourhood provider contracts, and integrated health organisation contracts).
It also asks general practice to ‘continue prioritising’ the use of Advice and Guidance ‘prior to, or instead of, a planned care referral’ where clinically appropriate, excluding referrals for urgent suspected cancer.
It added: ‘There should be a move to all referrals going via Advice and Guidance for the 10 specialties at provider level which have the most potential for this model to be effective. We expect ICBs to support this, and bring it to life, through their strategic commissioning for 2026/27.’
The document also said that from April next year, the NHS must being to make ‘at least 95% of appointments available’ after appropriate triage via the NHS App ‘across all care settings’.
It said that building ‘on existing general practice action plans’, in 2026/27 all ICBs must:
- ensure practices are delivering the 2025/26 GP contract (including recent 1 October changes) and the 2026/27 GP contract from April, including improving and providing ‘good access whether by phone, online or walk in throughout core hours’. This includes all patients knowing on the day how their request will be managed, and ‘increasing the number of people who can see their preferred healthcare professional’.
- put in place action plans to continue to ‘improve contract oversight’ and ‘tackle unwarranted variation’.
It said: ‘Central to the broader reforms we are delivering is continuing to focus on improving access to
general practice – this is critical to not only managing wider system pressures but also rebuilding the public’s faith in its NHS.’
Priorities for primary care and community services according to the document
• Improve access to primary care, including reducing unwarranted variation in access. Ensure 90% of clinically urgent patients are seen on the same day. We will consult with the profession on this new ambition and approach.
• At least 80% of community health service activity occurring within 18 weeks.
• Community pharmacy: maximise pharmacy first and roll out new services (emergency contraceptives and HPV vaccination).
• Maintain the additional 700,000 urgent dental appointments per year.
Health secretary Wes Streeting said: ‘This is the bold change this government promised in our NHS. Our ambition is nothing short of the fastest turn around in the history of the health service. Millions more patients will be treated on time, with better cancer outcomes and quicker access to GPs. The NHS will be brought into the digital age, and community care will be given the priority it deserves.’
NHS England CEO Sir Jim Mackey said: ‘For too long the NHS has been stuck in a doom-loop of not being able to properly plan beyond each financial year and responding to overly-bureaucratic processes that have stifled local leadership and innovation.
‘We have to get out of the trap of short term thinking and break the cycle of “just about managing”.’
In a statement in response to the document, the NHS Confederation said that it was ‘concerned about setting such a high target for GPs to see same-day urgent cases’.
NHS Confed chief executive Matthew Taylor added: ‘While our members recognise the need to prioritise access to general practice, adding such an ambitious target for the first time could significantly impact on the ability to deliver proactive and personalised care to patients which will risk worsening health outcomes and impact on the rest of the system.’
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Please note, only GPs are permitted to add comments to articles
Who decides what is clinically urgent?
The patient?
The health secretary?
My receptionist?
Me?
WIC?
A&E?
The DNs?
Community midwife?
CMHT who email at 5pm about 4 patients they saw 3 weeks back saying they all need urgent review?
Patchs AI?
Ha ha ha ha ha ha ha
No, please… you’re killing me
Woo hoo hoo hoo hoo
Gasp
Yes, quite. What is ‘urgent’ ?
I usually deal with all ‘urgent’ things within between 5 minutes and a couple of hours, but the trouble is that some patients may live up to almost 40 mins drive from surgery. If something is urgent there, I should be able to send ambulance instead. And quite often I don’t know where patient is, and cannot get hold of them on phone to ask if it is urgent, and where they are (furthest so far was in Japan, but east midlands, yorkshire and southwest England are common). And sometimes what has been put down, at request of patient, to be dealt with routinely next week, turns out to actually be very urgent when triaged! I reckon I get well over 90%, but I have deducted 2-3 patients per day assumed to be urgent, but unable to contact on phone for triage! (I also deducted the routine patients in routine slots.)
Only 90%?? Blinking lazy GP’s.
If we are plucking figures out of the air how about increasing funding for each patient by – oh I don’t know, 73% to allow more Gps to be actually employed.
Love how this is supposed to galvanise us to break out of the cycle of just about managing- presumably to the cycle of not at all managing.
I wish these kind of daily proclamations would reduce by 1 trillion percent
1) what’s urgent?
2) how do you measure what’s appropriately signposted to UTC (eg fractures) vs redirected due to full capacity?
3) do we measure those signposted to UTC or those who actually turn up? (Most we see the next day when they get in tiuch again having not gone)
4) is this going to be an imposed change, or negotiated with extra resource?
5) why are we prioritising same day access when proactive routine care reduces same day demand? Surely this target would just shove all routine patients into a six month waiting list?
And that’s all my thoughts in the first 30 seconds. It’s depressing the DH doesn’t know all this already when it’s their job to…
Wes (bless him) conflating same day urgent access with quicker cancer diagnosis, which of course is absolute rubbish, it will probably mean slower cancer diagnosis as we are forced to prioritise seeing people with the sniffles (as they will all know about this need to prioritise them) over and above people with subtly evolving symptoms that require thought and time
Simple. All practices to total triage- we decide what is urgent (have your most senior clinician triaging)- surprise surprise nothing is urgent. Priority given to those needing continuity and proactive care. Problem solved. Everyone else directed to UTC or pharmacy first.
Yawn …another loads of crap from this goverment. Unworkable or even undefinable rubbish polices.
Bold change…fastest turn around…millions more…blahdy blah – says Wes. Sounds like he and NHSE are aspiring to Kant’s categorical imperative willing their “beautiful” policies into universal law. In this, they are all Kants.
Don’t meet them on this battleground of their choosing – of corrupt vocabulary and fake negotiations. It’s time for the BMA to consider disruptive action to save general practice from these lunatics.
Lots of mention of GPs doing more but no
Mention of the resources to enable this . Darzi report last year ( commissioned by Labour) and CQC this year stated need for greatly increased resouces to primary care but no sign of that just more work ! Maybe time for mass resignation PCN DES or undated resignations from PMS/ GMS . They seem to want GPs to be all salaried , well at least then we can go on strike and demand a proper wage . Be careful what you wish for Wes . There is no money for all this , they can’t even afford the redundancy bills for NHSE!
So practices will have to keep their online access available 8am to 6.30 pm Monday to Friday and see 90% of urgents on the same day. The only way to do that will be to have at least one senior experienced clinician available to do total triage through the day and keep urgent appointment slots available up to 6.25 pm, just in case.
That will mean there will be less available appointments for the routine less urgent things. Waiting times for those are already getting to 2 weeks plus for many practices and will get longer.
I wonder what Streeting and Kinnock plan to do about that.
So the resident doctors are going to strike again
GPs cant work to safe access limits since 1st Oct
Now this
Sounds like were getting to the straw that breaks the camels back
Will Gps ever strike ???
Who in their right mind would want to be a partner around now ?
Unlimited liability
on the online access and the 90% urgent access
A+E Is not obligated to see everyone who is sat having a 12/24/36 hr wait
and often patients dont wait
or patients are advised to go back to 111 or own gp
Urgent
That’s easy
Letter for blue badge support
Letter for a new house
Letter to say blazer is itchy
The pill
Rash -has had for 10 years
ADHD and autism referrals
Fibro
Insomnia
Nits
TATT
Ok. You get the idea.
GPC should be pushing for an item of service contract which is not capped so that those who are driving demand ie politicians are responsible for the funding.
Unfortunately the block contract in place forced GPs to run faster for longer or take significant pay cuts to fund additional staff.
The BMA colleges etc should also accept that some form of copayment by users is the only way to ultimately ensure appropriate use of health services as the “ users” need to accept some responsibility regardless of economic or intellectual challenges
Since leaving the definition of “urgent” up to the patient would be a disaster, and putting a senior clinician on all day triage would be insane, then the only sensible solution is to figure out what is in fact “urgent”, (bearing in mind we are not an Emergency Service).
It’s interesting that Secondary Care does not treat “urgent “ referrals as “next day”, not even suspected cancer, so presumably the same should apply to Primary Care. We should have waiting lists as they do, until resources meet demand.
And meanwhile, if a patient badgers the receptionist with “But it’s URGENT !” then presumably it is an emergency, and as such they should be directed to A&E.
If all URGENT cases are sent to A&E, then ministers might rethink this unworkable hare-brained idiotic voter-appeasing idea.
There is finite capacity, inevitably chronic care will have to suffer. We have already had to move to yearly BP checks (we used to do it twice a year). More routine checks are being done online. Simply to free up capacity for acute problems which are often younger patients.
I read comments like Merlin Wyltt’s and I don’t feel so alone :’) hahaha.
The last one to leave please switch off the lights …
Effective actions could include refusing ridiculous recycled policies such as the impending Neighbourhood groups, aspects of the Fuller fantasy and other policies of this clueless government imo as could have been the case for PCNs who have acted as the main conduit for destroying the future of many younger GPs . The Junior doctors succeeded by making difficult decisions despite the lack of support from certain quarters as echoed by the countless negative remarks on medical social media platforms concerning the lack of support from certain senior members of the hopeless RCGP who are the butt of endless junior doctor anger.
So back to book on the day then?
Scrap the drive for continuity
Can’t have it both.
Except we’re NOT an emergency service. So maybe let GPs manage the system the way they know works.
Thanks Wes Streeting. Outing myself as a lifelong labour voter you’ve lost.