By March 2027, 90% of patients presenting with clinically urgent needs must be seen on the same day. That target, set in the NHS Neighbourhood Health Framework published on 17 March 2026, is now the access benchmark your practice will be measured against. The 2026/27 year is your baseline. What you record now shapes the trajectory ICBs will use to set your local target from 2027/28 onwards.
The good news: practices that are already running a structured total triage model are closer to this than they think. The challenge: practices that are not will struggle to evidence compliance even if they are delivering it clinically.
This post explains what the target means, how it is measured, and what your practice needs to do to get there.
What the 90% Target Actually Means
The obligation to provide same-day access for clinically urgent patients has been in the GP contract since April 2026. The Neighbourhood Health Framework added the specific threshold: 90% of those patients, same day, by March 2027.
Three things matter here.
Clinically urgent is defined by clinicians. The definition of clinical urgency under the 2026/27 GP contract is not set by administrators or receptionists. It is set by clinicians. This is deliberate. It protects practices from having to treat every patient who self-identifies as urgent as a same-day case. It also means your triage process needs to involve a clinical decision about urgency, not just a receptionist making a judgement call.
It is measured on recorded data, not clinical intent. This is the issue that will catch practices out. A practice might be seeing every clinically urgent patient on the same day, but if urgency is not being coded correctly and consistently in the clinical system, the recorded data will not reflect that. The 90% target is a data compliance problem as much as a clinical one.
2026/27 is a baseline year, not a grace period. The 90% target lands in March 2027, but the baseline you set in 2026/27 is what ICBs will use to track progress and set local trajectories from 2027/28 onwards. Practices that ignore the baseline year are not buying themselves time. They are starting from a weaker position.
Why Same-Day Access Is Not Just a Capacity Problem
The instinctive response to a same-day access target is to look at GP availability. More appointments, more GPs, more sessions. That logic is understandable, but it misses the point.
Same-day access for urgent patients is not primarily a capacity problem. It is a triage problem.
Consider two practices with identical GP capacity. Practice A has no structured triage. Contacts arrive through the phone, a receptionist creates a queue, patients are allocated slots in the order they called. Urgent contacts are mixed in with administrative queries, repeat prescription requests, and routine follow-ups. By 10am, same-day slots are full, and three genuinely urgent contacts have been offered next-day appointments because no one identified them as urgent early enough.
Practice B operates total triage. Every contact is assessed for urgency at the point of arrival, whether it comes by phone or online. Urgent contacts are flagged immediately and reserved for same-day slots. Administrative queries go to clerical staff. Prescription requests go to the pharmacist. The GP’s same-day capacity is protected for the contacts that actually need it.
Both practices have the same number of GPs. Practice B meets the 90% target. Practice A does not.
The difference is not capacity. It is the intelligence applied at the front door.
What Total Triage Does That Traditional Triage Cannot
Traditional triage is reactive and inconsistent. A receptionist takes a call, asks the patient what is wrong, makes a judgement call, and books accordingly. The judgement varies by receptionist, by time of day, by how busy the day is. There is no consistent urgency coding. There is no structured data on what patients presented with or where they were directed. There is no audit trail.
Total triage is structured and systematic. Every contact, whether online or by phone, goes through the same process. The presenting problem is captured in a structured format. An AI-driven system assesses urgency against clinical criteria. The contact is coded and routed. The data is recorded.
The result is threefold:
- Urgent patients are identified consistently and protected from being buried in a general queue
- Non-urgent contacts are redirected to the appropriate team member, protecting GP same-day capacity
- Every decision is recorded, coded, and auditable
That third point is what makes the difference for the 90% target. You cannot demonstrate 90% compliance without a system that records urgency at the point of triage. Manual triage produces no such record. Total triage produces it automatically.
The Data Problem Practices Cannot Ignore
The framework is explicit: the 90% target is measured on recorded data. That creates a specific risk for practices that are clinically compliant but operationally unprepared.
If your clinical system does not have a consistent urgency coding process, and if that coding is not being applied at the point of first contact, you have no way of demonstrating what you are delivering. Your ICB will see a blank or inconsistent data set. You will appear non-compliant even if clinically you are seeing every urgent patient on the same day.
This is not a theoretical risk. Practices have faced this exact problem with QOF indicators, where clinical delivery was sound but poor data recording led to under-performance on paper. The 90% target creates the same dynamic at scale.
The fix is not complicated. It requires:
- A triage system that codes urgency at first contact, every time
- A clinical system where urgency categories are used consistently
- A process for verifying that recorded urgency reflects clinical reality
- Regular data audits to check coding accuracy before formal reporting begins
The 2026/27 baseline year is the time to fix this. If your coding is inconsistent now, you have months to correct it before the March 2027 target is formally measured.
How Klinik-Using Practices Are Already Building the Evidence Base
Practices operating Klinik’s total triage platform are generating urgency data as a byproduct of their normal operations. Every contact, whether submitted online or entered by staff from a phone call, goes through Klinik’s AI-driven urgency assessment. The system codes every contact and generates a structured record of what the patient presented with, what urgency level was assigned, and what happened next.
That data is already there. The practice does not need to build a new reporting process to meet the 90% target. The audit trail exists.
Independent evidence from Klinik-using practices shows what this looks like in real terms. At Priory Medical Group in York, 70% of patient contacts were fully handled or actioned within 24 hours following Klinik implementation. At one practice, phone wait times dropped from 99% of contacts to 30% after total triage went live, with calls answered within 5 minutes rather than 30. These are not just satisfaction metrics. They are evidence of a system that is correctly routing urgent demand and protecting clinical capacity.
The Neighbourhood Health Framework does not specify which triage system practices should use. It specifies the outcome: 90% of urgent patients seen same day, evidenced by recorded data. The question for every Practice Manager is whether their current triage setup can produce that evidence.
A Six-Step Readiness Checklist
Step 1: Audit how urgency is currently defined and coded in your practice. Is there a consistent clinical definition of urgent? Is it being applied at triage? Is it being coded in your clinical system?
Step 2: Map where same-day capacity is currently going. What proportion of same-day slots are genuinely being used for clinically urgent patients? What is being absorbed by contacts that could have gone elsewhere?
Step 3: Review your triage process for consistency. If triage decisions vary by receptionist, time of day, or patient presentation channel, you do not have a reliable basis for data compliance.
Step 4: Ensure your online and telephone channels are producing equivalent data. A patient who calls must produce the same structured record as one who submits online. If telephone contacts are not being triaged through the same process, your data will be incomplete.
Step 5: Set up a monthly data review. Track urgency coding rates, same-day access rates, and any gaps between clinical delivery and recorded performance. Do this now, during the baseline year, so you can correct problems before they become compliance issues.
Step 6: Talk to your ICB about local expectations. The framework sets the national floor. ICBs will set local trajectories. Knowing what your ICB is expecting during 2026/27 gives you a clearer target to build towards.
Frequently Asked Questions
What counts as clinically urgent under the 90% target?
The definition of clinically urgent is set by clinicians, not administrators. The framework explicitly protects this to ensure clinical decision-making remains central. In practice, your practice should have a written clinical definition of urgency that is applied consistently at triage and coded accordingly in your clinical system.
Does the 90% target apply to all patients or just those who self-report as urgent?
It applies to patients assessed as clinically urgent through your triage process. Patients who self-identify as urgent are not automatically classified as clinically urgent. The clinical assessment at triage is what determines the coding and, by extension, what is counted in the 90% figure.
What if my practice is already seeing urgent patients same day but not coding it?
Your clinical compliance does not count if it is not recorded. The target is measured on data from your clinical system. Urgency coding must be applied at the point of triage, consistently, for the data to reflect what you are actually delivering.
When does the 90% target formally apply?
March 2027. The 2026/27 year is a baseline year. Your recorded data during this period will be used by your ICB to set local trajectories. Poor baseline data creates a worse starting position for 2027/28 targets, even if clinical performance is sound.
Does total triage mean all patients go through an online form?
No. Total triage means all contacts, however they arrive, are triaged through a consistent process. Phone contacts can be captured by staff entering the patient’s presenting problem into the triage system, generating the same structured record as an online submission. The goal is consistent urgency coding across all channels, not forcing patients online.
How does Klinik support same-day access compliance?
Klinik captures every contact in structured form across both online and telephone channels, applies AI-driven urgency assessment, codes each contact, and routes to the appropriate team member. This generates the auditable record of urgency and outcome that ICBs will require for the 90% target. Practices using Klinik are already building this evidence base in real time.