Enhanced access

Where a practice has signed up to the Network Contract DES, it is obliged to offer extended hours access, and from 1 October 2022 enhanced access, to its registered patients via the PCN.

It will be for the PCN to determine how that offer is made available to all its registered patients.

For extended hours access (until October 2022), the additional appointments provided by a PCN are to be held at times that take account of patient’s preferences and are outside core hours. 


For enhanced access (from October 2022), the Network Standard Hours (NSH) will cover 6.30pm-8pm during the week.


a PCN’s minimum number of appointments per week may:

i. be delivered concurrently where they exceed the NSH; and/or

ii. with agreement from the commissioner, a proportion may be delivered in continuous periods of at least 30 minutes outside of the NSH to better meet the needs of the PCN’s patients, for example, to:

• provide appointments prior to 8am on weekday mornings or 9am on Saturday morning; or
• provide appointments after 8.30pm on weekday evenings or 5.30pm on Saturday evenings


Where a Core Network Practice is required to provide core services at its premises after 6.30pm, the patients of that practice must also have access to enhanced access appointments, and the enhanced access appointments must be in addition to the appointments offered as part of that practice’s core hours service offer.

Core Network Practices within a PCN are collectively responsible for the delivery of extended hours access and, from 1 October 2022, enhanced access.

PCNs have the flexibility to sub-contract extended hours access or enhanced access services to other providers.

The delivery of extended hours access through the Network Contract DES will be in addition to any CCG commissioned extended access services.

It will be up to the PCN to determine the delivery model for extended hours access and enhanced access, but PCNs will need to ensure this service is offered to the entire PCN population.

enhanced access Utilisation suggestions

  • QoF clinics
  • Childhood immunisation clinics
  • Flu clinics
  • Covid clinics
  • Healthchecks
  • LES clinics
  • LTC clinics
  • Smear clinics
  • Embargoed slots for urgent / acute care


For Enhanced Access from 01 October 2022 to 31 March 2023, payments under the Network Contract DES will be made using PCN Adjusted Populations. The formula used to calculate these populations includes a 15% adjustment to recognise inequalities and unmet need, and the same Adjusted Populations are used for the calculation for the number of minutes which PCNs are required to provide in Enhanced Access (60 mins per 1000 population, based on the PCN Adjusted Population).


Key points

  • Enhanced access does not mean that every practice has to extend its opening hours
  • It is not a requirement to open on Sundays or bank holidays
  • It is fine to use ARRS team members as part of the enhanced hours MDT
  • There is no “number of appointments” target
  • There is no “utilisation” target
  • There is no “appointment duration” target