NHS England intends to “improve operational grip” on GP performance and has warned it may lead to “contractual action”.
NHSE board papers reveal it is introducing “a range of actions” designed to “strengthen” its confidence in improved primary care performance.
The actions include: “Agreeing local improvement trajectories and recovery plans where required; [and] disseminating best practice from high performers.”
Individual practices will receive “tailored letters” detailing their performance and stressing the “potential for contractual action” should they fail to meet required standards.
The 2026-27 GP contract requires practices to deal with all patients they identify as being clinically urgent on the same day.
NHSE has set a national target of 90%, first announced in the medium-term planning framework in October 2025. The subsequent neighbourhood health framework said the NHS aimed to achieve this by March 2027.
No integrated care board area is currently reaching the target.
Practices themselves decide which patients are clinically urgent. NHSE guidance says this is “a prospective judgement made on the basis of the information available at the point of first assessment”, rather than a retrospective one.
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Source: HSJ, 2 October 2026
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