Those that offer extended opening hours and operate open lists will be rewarded, while those that open only during the core GMS hours could find their profits eroded.
The DoH wants incentives for practices to take on new patients. As part of this, the upcoming GMS funding formula review for 2007/8 will look at ways of ensuring a greater proportion of funding follows the patient.
The White Paper says: 'We will ask NHS Employers to consider the case for establishing an expanding practice allowance for practices that have open lists and extended opening hours. We will expect PCTs to prioritise expanding practices when allocating strategic capital monies.'
Rather than dictating practices' hours, DoH director of primary care, Dr David Colin-Thome, said PCTs would be responsible for ensuring that some primary care services opened outside core times in their area if patients wanted it.
As previously reported, practices in England will be rewarded through the directed enhanced service (DES) for access, for providing 48-hour access and an advance booking system.
From 2007, the DES will include a standardised, independently conducted survey asking patients whether their surgery offers convenient opening hours and early morning, evening and Saturday surgeries.
RCGP chairman Dr Mayur Lakhani said that, while access needed to be improved, there were capacity issues: 'If you do an evening session that has to come from another part of the week. We don't want to over-work doctors and nurses.'
The White Paper has also called time on practices that have 'open but full' lists. New list closure procedures will be implemented from 2007/8 and practices will be classified as either open or closed.
The DoH has rejected dual registration because it would undermine continuity of care, and would be difficult and costly to introduce. Instead, the White Paper promises more walk-in centres and incentives for practices to provide services to non-registered patients. Out-of-hours providers will also be encouraged to run evening surgeries and take patient registrations.
Rules on registration will be reviewed in 2007/8 with the aim of relaxing practice boundaries so that 'patients will be guaranteed acceptance on to an open list in their locality'. While practice boundaries will grow, the White Paper makes no mention of relaxing the requirement for home visits.
PCTs' duty to inform local residents will include information on the establishment of new services and expanding practices.