Improving same day access to primary care

22 February 2024

An update to this article was issued on 6 March 2023 - you can read it here

An ambitious plan to improve same day access to primary care for patients is being introduced by NHS North West London.

The plan involves the use of same day access hubs to triage patients who contact their general practice. These hubs will include senior GPs and a multi-disciplinary team of clinicians and non-clinical staff drawn from practices in the area. They will assess patients’ needs and refer them to the best service for them. This may be an urgent or routine appointment with their GP, an appointment with a community pharmacist or other clinician or guidance on how best to treat their condition.

Where appointments at a patient’s own practice are not available, they may be referred to another practice so that they can be seen the same day. Same day access hubs will be delivered by local primary care networks in each area. They may be physically co-located or virtual services.

Dr Genevieve Small, Harrow GP and Medical Director, Primary Care NHS North West London said:

“Patients consistently tell us that getting a GP appointment can be difficult. We have developed a plan that will increase same day access to GPs, community pharmacists and other primary care professionals for those patients who need it.

“This approach will be introduced gradually across North West London from April 2024. It will ensure that GPs have more time to proactively care for their patients who most need their expertise, including those with long term conditions.

“I want to be clear that clinical decisions and referrals will continue to be made by clinical staff. Non-clinical staff such as care navigators and coordinators will support by signposting patients to the right service for them, based on clinical advice – in much the same way that practice reception teams work, but with closer clinical supervision.

“Same day access hubs have been successfully piloted in 10 primary care networks. We will be introducing them gradually, in line with local needs and developed flexibly with primary care networks who understand their populations best.”


Frequently asked questions

Why is NHS North West London introducing same day access hubs?

We want to increase access to primary care services for patients. The most consistent message we hear through talking to residents and patients is that access to primary care is difficult: they are struggling to get through to their GPs or to get a timely appointment, especially when they need one the same day.

Same day access hubs bring GP practices together in networks, making it easier to arrange appointments the same day and to support patients in finding the care that is best suited to their needs. Patients who need a GP appointment that day are more likely to get one and GPs will be able to focus on providing proactive care to patients who need it. Where appropriate, patients may be referred to other services best suited to their needs, such as community pharmacists, physiotherapists or nurses. GPs will continue to see patients who need to see them and will be able to offer proactive continuity of care to people with long term conditions and others who need it.

Will I still be able to see my GP?

Of course. The aim of this programme is to make access to GP appointments easier for those who need them.

Will non-clinical staff such as Care Navigators and Care Co-ordinators be making decisions about my care?

No. All clinical referrals and clinical decisions will be made by clinicians. Those in supporting roles like Care Navigators and Co-ordinators will signpost patients to the right care for them. They will work in an identical way to how they work in practices now, but with greater clinical oversight as the same day access hubs will all include senior GPs and multi-disciplinary teams and with a better understanding of the types of services that might support their population’s needs.

Will I have to travel further for care?

Where appointments are needed the same day and no slots are available at your local practice, it is possible that you might be referred to a different practice, in much the way patients sometimes see different GPs out of hours. You may also be referred to another service such as a community pharmacist if they could better meet your needs.

This might involve travel in some cases, but not all same day access hubs will be physically co-located: it is for local primary care networks to decide whether their hubs are physical or virtual. Patients can currently move to other local practices to access some services such as physiotherapy, ECG testing or particular services not available at their own practice location. This will work in a similar way.

What influence can patients have on the new system?

We are asking primary care networks to work with their patients to co-design the same day access hubs and how they will work in their area.

Are GPs being mandated to introduce same day access hubs?

Same day access hubs form part of our 'single offer' to general practice which which aims to introduce a consistent approach to enhanced care across North West London. If practices are not part of same day access hubs, their patients may have to travel to other providers to access more specialist services like improved diabetes services and childrens’ blood tests.

Are same day access hubs there to provide appointments when a practice has none left?

No. Same day access hubs are about ensuring more patients get the help they need the same day. They are not  a ‘surge’ service for when practices run out of appointments. This is about pooling all the clinical resources in an area – GPs, community pharmacists, nurses, physiotherapists and other clinicians – to ensure people can quickly access the care they need.


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