The 2026/27 General Practice Contract introduces a new requirement that all requests identified as clinically urgent must be dealt with on the same day.
While many practices already prioritise urgent clinical need, the contractual requirement places additional emphasis on ensuring that urgent requests are identified, managed appropriately, and recorded consistently.
What Does the Requirement Mean?
Under the 2026/27 contract, GP practices must ensure that any patient request considered clinically urgent is dealt with on the same day.
Importantly, it is the practice that determines whether a request is clinically urgent. This allows practices to use their existing clinical triage systems and professional judgement to identify patients who require same-day assessment or intervention.
The intention behind the change is straightforward: to ensure that patients whose condition may deteriorate or result in harm if delayed receive timely access to care.
Supporting Guidance Now Available
To help practices implement the requirement consistently, NHS England has published supporting guidance covering:
- How to record same-day appointments for clinically urgent patients
- National category mapping guidance to support accurate recording
- Frequently asked questions addressing common operational queries
- A technical support webinar explaining the requirements in more detail
These resources are available through FutureNHS and NHS England channels.
Why Recording Matters
As with many contractual requirements, delivery is only part of the picture. Practices should also ensure that their systems and processes enable them to demonstrate compliance.
This means considering:
- How urgent requests are identified at the point of contact
- Whether triage pathways are clearly documented
- How same-day responses are recorded within the clinical system
- Whether staff understand the definitions and processes being used
- How practices can evidence compliance if asked by commissioners or regulators
Accurate coding and recording will be particularly important where practices are using telephone consultations, digital triage, multidisciplinary teams, or care navigation models to manage urgent demand.
Practical Steps for Practices
If you have not already done so, now is a good time to:
✓ Review your current triage and urgent care processes
✓ Familiarise clinical and administrative staff with the new requirement
✓ Review the national category mapping guidance
✓ Check how your clinical system records clinically urgent contacts
✓ Ensure your governance systems provide oversight of access and urgent care pathways
The Bigger Picture
Although the contractual requirement is focused on access, it also links closely with patient safety, governance, and quality assurance.
Practices that have clear systems for identifying risk, documenting decisions, and demonstrating how urgent needs are managed are likely to find it easier to provide assurance both to commissioners and during any future CQC inspection activity.
As always, the key is not simply doing the work but being able to evidence that the work is happening consistently and effectively.
For practices reviewing their governance arrangements this year, urgent access processes may be one area worth revisiting to ensure they remain fit for purpose under the evolving contractual and regulatory landscape.