Contract negotiations between the DoH and GP leaders collapsed in December because GPs rejected a deal to open practices for three hours more per week on average.
The plan would have relocated access and choice and booking directed enhanced services cash to extended hours, and diverted 58.5 quality framework points to pay for access. The total contract value was to rise by 1.5 per cent, possibly for extra work.
The GPC offered two hours extra opening per average practice per week, and the DoH is now threatening to impose a worse deal from April, that would cut 135 points from the quality framework, stripping £17,000 a year from the average practice.
Practices could lose a further £19,000 unless they negotiate local deals for extended hours.
RCN Nurse Practitioners Association chairwoman Jenny Aston said: 'I think that nurses will vote with their feet, and more will go part time.'
She added that nurses may not want to work longer hours and surveys show most patients were happy with existing hours.