GPs in England must keep their surgeries open for longer to meet demand from patients, or risk losing funding, Downing Street has warned.
It said many patients were going to under-pressure A&E departments because they could not get appointments.
The government wants to see surgeries open between 08:00 and 20:00, seven days a week, unless they can prove the demand is not there.
The British Medical Association accused ministers of "scapegoating" doctors.
Downing Street said surgeries should do more to ensure they offer appointments in the evening and at weekends.
It said: "Most GPs do a fantastic job, and have their patients' interests firmly at heart.
"However, it is increasingly clear that a large number of surgeries are not providing the access that patients need - and that patients are suffering as a result because they are then forced to go to A&E to seek care.
"It's also bad for hospitals, who then face additional pressure on their services."
It comes as figures show more than four in 10 hospitals in England declared a major alert in the first week of the new year as they faced unprecedented pressures.
Number 10 said ministers had been shown evidence that some GP surgeries were failing to tell patients about extending hours for appointments or ensuring they were at convenient times.
It said those who were not seen outside working hours were "left with little option" but to go to A&E.
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