Primary care trusts will have to demonstrate 'tangible improvements' in patients' access to GP services by the end of the year.

The Department of Health has written to all PCTs and strategic health authorities demanding they produce local action plans by the end of September. The plans will be checked by SHAs 'to ensure sufficient ambition and challenge', the letter said.

It follows the results of the patient experience survey last week, which found that patients who were young, from deprived areas, from black or minority ethnic groups or from urban areas were less satisfied with GP access.

DoH director general of commissioning and system management Mark Britnell made clear in the letter that no trusts were exempt from the need to make changes.

'Even in high-performing PCTs there are pockets where improvements are clearly needed,' he said.

A new Healthcare Commission performance indicator based on data from the survey 'will ensure that low-scoring PCTs that do not make the improvements that their patients want to see will have their ratings marked accordingly', he added.

Mr Britnell said SHAs should set up teams of managers and clinicians to drive progress. He stressed that he expected to see responses tailored to local needs.

Meanwhile, the GP workload survey, published this week, has revealed that GPs on general medical services contracts work an average of 36.2 hours a week, while those on personal medical services contracts work 33.7.

British Medical Association GPs committee chairman Dr Laurence Buckman said the difference in hours was because there are more part-time doctors on the PMS contract.

An NHS Employers spokesperson said the difference in working hours depended on a number of factors, including practice population, size and skill-mix of practice staff.

'This will be useful information for PCTs when they are considering the best way to contract services for their local populations and to deliver value for money.'

Staff from 329 practices took part in the survey.

Click here to read HSJ' analysis on inequalities