Practices performing poorly in the patient experience survey will be invited to submit business cases to PCTs, explaining how they would use extra resources to improve access and patient satisfaction.

Practices already scoring highly could apply for cash to develop ‘more innovative approaches to reach people who do not normally access primary care,' says the document, from Primary Care Commissioning, a network of PCT advisers.

It was agreed in the 2008/9 contract settlement that £50m would be added to PCT allocations to boost ‘access and responsiveness', but the GPC warned in May that there was no way of finding out how or even if PCTs were spending it.

GPC negotiator Dr Chaand Nagpaul welcomed the guidance but was not confident that PCTs would translate it into cash for practices.

‘The crux is whether PCTs have the resources and make them available, or whether this becomes an aspiration that gathers dust.'

Dr Nagpaul also warned that the process of submitting business cases must not be ‘disproportionately bureaucratic' to the funding available.

Areas suggested for practices to improve include making sure premises comply with the Disability Discrimination Act and agreeing to make a higher number of GP or nurse appointments available.

The guidance states there will be no fixed price for the services and once investment is agreed, regular monitoring visits and extra patient surveys would track practices' performance.

• Read the full version of this story in this week's GP dated 2 October.