Table 1.

National policies to extend the opening hours of general practices in England

	(a) Prime minister's GP access fund	(b) Extended hours access scheme
What is the policy?	Dedicated funding of local schemes designed to improve access to general practice. Practices must offer routine appointments from 08:00 to 20:00 on weekdays and improved access at weekends. Some schemes involve practices working in groups to provide additional appointments and the use of telephone and online consultations. The prime minister has pledged that all general practices will offer routine appointments from 08:00 to 20:00, 7 days a week, by 2020.	Payment for general practices providing appointments outside of times included in contracts (08:00 to 18:30, Monday to Friday for most practices). Practices must provide at least 30 min of additional appointments per 1000 registered patients weekly. Appointments can be with any health professional and must be in addition to normal provision during contracted hours. Sessions can be provided concurrently, for at least 30 min. Participating practices earn £1.90 per registered patient per year.
When was it introduced?	First wave of pilots planned from October 2013 to April 2014; second wave planned from September 2014 to March 2015.	2008; revised for 2014–2015 (to allow practices to offer telephone and online appointments and work in groups to meet requirements).
How many practices have participated?	Around 2517 (1100 from first wave; 1417 from second wave).	5877 (of 7959; 74%) in 2014–2015.
What has been the effect?	Mixed evidence from relevant evaluations in Greater Manchester and London; low demand in some areas.	Unknown.
How much does it cost?	£175 million investment so far (£50 million first wave; £125 million second wave).	£84 million per year (2014–2015 figure).

General practices in England have registered populations of patients for whom they are contracted to provide primary care. They provide comprehensive, continuous services and are generally the first point of contact within the system. Most practices are contracted to open from 08:00 to 18.30, Monday to Friday. Outside of these times, separate out of hours services are available; these vary widely but often include telephone-based care. Urgent and emergency care services range from consultant-led emergency departments to general practitioner or nurse-led services intended to treat minor illnesses that are accessible without appointment. Other services include a national telephone helpline and pharmacists.