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GMS contract 2026-27: appointment mapping

  • GP contracts

Standardised GP appointment category mapping was introduced in the PCN DES from 2021, this is an update to the original guidance produced by Londonwide LMCs in response to the 2026/27 GMS contract changes.  

NHS England’s appointment mapping guidance can be found here.

The data recorded as care related encounters is being used to provide national reports on GP activity. This will include reporting on unused appointments. It does not accurately record or measure other essential GP activity including all the clinical administrative work which practices can record under care related activity or work essential for running the practice including staff supervision and training which practices can record under administration and practice staff activity.

Appointment mapping was introduced to better capture general practice workload and demand.

  • Practices are required to map each slot type it uses to one of the national categories (Appendix 1).
  • The original piloting suggested that this exercise takes around one hour per practice.
  • The currently used national categories have been available within all GP clinical system since the end of March 2021.
  • The GPAD data collection for appointment mapping does not include unplanned clinical activity, home visits and other essential practice activity including all the clinical administrative work which practices can record under care related activity or work essential for running the practice including staff supervision and training which practices can record under administration and practice staff activity.

Changes in the GMS contract 2026/27

The GMS contract 2026/27 creates a new requirement that patients identified by the practice as clinically urgent must be dealt with on the same day.  GPAD will also be reporting on the number of routine appointments offered within 7 and 14 days.

The national categories of appointments do not include a ‘same day appointments for clinically urgent patients’ category.  Any consultation that is undertaken due to being classified as ‘clinically urgent must be dealt with on the same day’ should be mapped to the General Consultation Acute national category.

For appointments which are non-clinically urgent and being booked within either 7 or 14 days, the appointment slots should be mapped to ‘general consultation routine’ or ‘care home visit’.

Each month NHS Digital will publish the percentage of appointments which were clinically urgent and dealt with on the same day. This will be calculated from the number of appointments mapped to ‘general consultation acute’ which took place on the same day (utilises the time from booking to appointment data) as a proportion of the total number of appointments mapped to ‘general consultation acute’. A similar calculation will be made with the 7- and 14-day appointments.

Londonwide LMCs full 2026-27 contract guidance

Action for Practices

  1. Review appointment templates and check that the context types and the national categories are correct (Appendix 1)
  2. Review the practice GPAD data:
    1. A low proportion of appointments mapped to the ‘General Consultation Acute’ category for a practice that provides care for clinically urgent patients may suggest this category is not being used appropriately.
    2. A high proportion of appointments mapped to the ‘General Consultation Routine’ category taking place on the same day may suggest clinically urgent activity is being booked into slots mapped to non-acute national categories.
  3. Remove surplus appointments. Some practices set up their appointment systems so that there are sufficient appointments in the appointment system to manage whatever patients call. These are contingency slots and not actual appointment slots and may be utilised for triage lists, home visit lists etc. To prevent inaccurate reporting of capacity and utilisation rates these slots should be deleted at the end of a session. This is different from unused slots which are true appointment slots which have not been used.
  4. Ensure that all care related encounters are recorded. It is common practice that when a patient phones reception needing advice that if the GP is available the call is just put through, with no record of this in the appointment system. Or when GPs are reviewing letters/results, which need a consultation with the GP, that they just call the patient up to discuss the issues. We would encourage practices to move to a system where all these types of unplanned contacts are added to the clinical system as extra or squeezed in appointments.
  5. Accurately record the mode of consultation. The appointment system is normally set up with a default appointment type, most frequently telephone or F2F but it could include video or online. If consulting and the mode of consultation is different from the default type then this should be changed within the medical record. Accurately recording the mode of consultation is important not just for data collection but can also be relevant for medicolegal purposes.

Definition of an appointment

It is important that practices understand which encounters are considered a consultation and accurately report these.

The following definition has been agreed: “discrete interactions between a health or care professional and a patient, or a patient’s representative”

This definition excludes:

  • Triage of Online requests that do not result in an interaction between the patient and a health or care professional. This impacts on practices that are utilising digital triage models as often the GP triaging will not have a direct interaction with the patient yet is making clinical decision by prioritising the patient’s needs and ensuring that they are booked with the most appropriate health care professional.
  • Purely administrative interactions between practice staff and patients e.g. practice manager meeting a patient to complete a subject access request or a receptionist answering a query about opening hours.
  • Non-clinical triage or administrative signposting.
  • Work undertaken by a health or care professional that doesn’t involve patient contact e.g. multi-disciplinary team meetings, case conferences, palliative care list reviews, referral letters, writing repeat prescriptions, reviewing results.
  • All clinical administration activity including audit, training, supervision.
  • Interactions with patient participation reference groups.

The definition of an appointment includes:

  1. All relevant staff. Discrete interactions carried out by any health or care professional, including all roles in the Additional Roles and Reimbursement Scheme.
  2. All modes. Discrete interactions that are delivered by all modes – face-to-face, by telephone, via video and online.
  3. All settings. Discrete interactions in any primary medical care setting (including the practice, patient’s home, community, care home, group consultations, local GP extended access hub).

As has always been the case, Did Not Attend (DNA) appointments should continue to be recorded

Appendix 1: GP Appointment Categories and mapping process

For each slot type determine:

  • General practice – this should be applied to all appointments delivered by practice staff activity under the GMS/PMS/APMS contract.
  • Primary Care Network – this should be applied to:
    • Appointments delivered by staff employed or engaged under the Additional Roles Reimbursement Scheme (ARRS)
    • Appointments delivered in fulfilment of the service requirements of the Network Contract Directed Enhanced Service (DES) – e.g. Structured Medication Reviews, weekly care home rounds – with the exception of Extended Access services, for which the Extended Access Provision service setting should be used.
  • Extended access provision – this should be applied to all appointments commissioned as part of extended access contractual arrangements
  • Other – this can be applied to record appointments delivered in the practice by another provider (if the system appointment book is used to record this activity) or under a separate contract/commissioning arrangement, such as CCG-led sexual health services.
  • Care related encounter: These categories involve the patient and can be any modality e.g. face-to-face appointments, telephone consultations, video and online consultations, home visits etc.
    • There are 17 national categories within this context type (chart C)
  • Care related activities: These categories do not involve the patient but are about the patient; clinical tasks and activities undertaken on behalf of the patient.
    • There are 3 national categories within this context type (chart D)
  • Administration and practice staff activities: These categories are for all activities and tasks required for managing a general practice and its staff.
    • There are 6 national categories within this context type (chart E)

Practices are not expected to use the appointment book to record all the activities captured by the ‘Care related activities’ or ‘Administration and practice staff activities’ context types.

Appointments recorded under the ‘Care related activities’ and ‘Administration and practice staff activities’ context types will not be used to measure the extent to which these activities are taking place. Rather, a primary purpose of these ‘Care related activities’ and ‘Administration and practice staff activities’ context types is simply to distinguish these activities from care-related encounters in order to form a better view of general practice workload – we want to be able to remove them from any count of patient-facing encounters in order to form a better view of demands on general practice.

Further NHS Digital information on setting

C – National categories for patient encounter
Is this a routine, planned and available in advance slot?Yes →General consultation routine [2]
No ↓
Is this an urgent and acute appointments made available on the day or < 24 hours and booked in
advance of attendance?		Yes →General consultation acute [1]
No ↓
is this a walk-in slot booked on presentation of a patient?Yes →Walk-in [6]
No ↓
Is this a triage slot primarily to assess or direct / signpost a patient but may be a one-stop service?Yes →Clinical triage [7]
No ↓
Is this an extra emergency slot created on the day to meet excess demand?Yes →Clinical triage [7]
No ↓
Is this a planned but specific activity / clinic involving assessment, planning and or treatment?Yes →Planned clinics [3]
No ↓
Is this a planned and known intervention, investigation or skill / equipment specific treatment?Yes →Planned clinical procedure [4]
No ↓
Is this a home visit of the patient, either planned or reactive?Yes →Home visit [8]
No ↓
Is this a visit to the care home / nursing home of the aptient, either planned or reactive?Yes →Care home visit [9]
No ↓
Is this a group consultation / encounter involving more than one patient?Yes →Group consultation and group education [10]
No ↓
Is this a slot for the specific task of a structured medication review?Yes →Structured medication review [11]
No ↓
Is this a slot for the specific task of a DES enhanced home care review?Yes →Patient contact during care home round [12]
No ↓
Is this a slot for care home needs assessment, personal care or support planning?Yes →Care home needs [13]
No ↓
Is this a slot for care co-ordination or social prescribing?Yes →Social prescribing service [14]
No ↓
Is this a slot for care prescribing by outside provider?Yes →Service provided by organisation external to the practice [15]
No ↓
Is this a practice private (non-NHS) clinical work?Yes →Non-contractual chargeable work [16]
No ↓
Patient Encounter slot not reported as an appointment by agreed definitionYes →Care related encounter but does not fit into any other category [17]

 

D – National categories for clinical care related administration
Is this a slot for administration and activity supporting or relating to the care
of an individual patient?		Yes →Patient clinical admin [18]
No ↓
Is this slot for advising and activity relating to multiple patients or involving more
than one clinical staff?		Yes →Multidisciplinary team meeting [19]
No ↓
This is other care related activity not defined aboveYes →Care Related Activity but does not fit into any other category [20]

 

E – National categories for practice administration
Is this a slot for a break, catch-up or absence?Yes →Break and staff absence [25]
No ↓
Is this a slot for clinical housekeeping / preparation?Yes →Clinical housekeeping / admin [24]
No ↓
Is this a slot for business and practice management activity?Yes →Business / practice management activities [23]
No ↓
Is this a slot for providing training / mentoring (no patients)?Yes →Providing training / mentoring [21]
No ↓
Is this a slot for receiving training / being supervised (no patients)?Yes →Receiving training / being supervised [22]
No ↓
Is this other admin and staff activity?Yes →Admin and practice staff related activities but does not fit into any of the above [26]