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The GPC and NHS Employers are currently in negotiation about whether extended hours should be funded as an enhanced service, however national or directed services are options.

Mark Britnell, director general for commissioning and system management in the NHS, told the National Association of Primary Care conference on service redesign in primary care in London last week, that all services would be locally commissioned.

‘It’s time for PCTs to stand up to the plate,’ he said.

He added that practices planning to offer extended hours in exchange for daytime closure would have their hopes dashed.

GPs will be expected to offer additional hours and not substitute opening times, he said.

‘We are not expecting you to substitute hours. We are expecting you to add hours,’ Mr Britnell said.

‘If practices don’t want to open longer, we will think about inviting others that do,’ he added.

However, he was contradicted by health minister Ben Bradshaw later at the same conference who said that extended hours did not necessarily mean more hours.

Mr Bradshaw said that practices could ‘close for the morning and open in the evening instead’ when asked about how extended hours would be resourced.

Mr Bradshaw, who was booed after he spoke, called for GPs to show a ‘positive spirit’ but admitted the government would have to look ‘imaginatively’ at how to support GPs opening longer.

Speaking at a GPC briefing last week, GPC chairman Dr Laurence Buckman said that there could be a national or directed enhanced service for extended hours.

tom.ireland@haymarket.com

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