Practices that are 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 £50 million 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 he 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,' he said.
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 (see below).
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.
Dr Nigel Watson, chief executive of Wessex LMCs, said many practices will be inexperienced at pricing the services they provide and developing a business case.
'I'd prefer to see an enhanced service so you could see it all laid out first,' he said.
'But it's something I would welcome if the funding is recurrent - too often the funding is one-off and then it stops.'
Dr Watson questioned the logic of penalising practices financially with the patient survey then deciding to fund them.
'But it could be a good mechanism for helping under-funded practices improve their services,' he said.
How practices can earn a share of £50 million:
- Reach an agreed standard on 48-hour access
- Ensure a certain number of GP/nurse appointments per week
- Record and act upon feedback from a patient participation group
- Undertake extra patient surveys
- Target hard-to-reach groups
- Premises comply with the Disability Discrimination Act