The general theme of Mr O'Brien's speech to the RCGP conference in Glasgow on Thursday was the emphasis on quality of care enabling savings to be found.

He warned that, although the quality framework would not be changed in 2010/11, negotiators should seek to be ‘bold' afterwards.

He said: ‘At the very least we need to raise existing payment thresholds to reflect existing levels of achievement by the best performing practices.'

He used the example of MRSA improvements and keyhole surgery to show that advances in quality of care could also save money.

He added: ‘The way forward is not 80s-style slash and burn cuts.'

He pledged that a patient's right to an extended hours consultation in the evening or on a Saturday morning would be enshrined within the NHS Constitution within five years and reiterated the government's ambition for all practices to extend hours.

He said RCGP chairman Professor Steve Field and primary care czar Dr David Colin-Thomé would report back to him on out-of-hours care and hinted that a finding of their review could be that GPs should have a greater commissioning role, which is Conservative policy.

Mr O'Brien also plans to ‘name and fame' healthcare professionals who come up with best practice schemes.

Find more about the Royal College of General Practitioners (RCGP) on Healthcare Republic