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Enhanced services

  • Last modified date:
    2 September 2008

Enhanced services are services not provided through essential or additional services, or essential and additional services delivered to a higher specified standard. They were negotiated into the GMS contract as a key tool to help PCTs reduce demand on secondary care. Their main purposes are to expand the range of local services to meet local need, improve convenience and choice, and ensure value for money. They were designed to provide a major opportunity to expand and develop primary care, and give practices greater flexibility and the ability to control their workload.

There are three types of enhanced service:

  • Directed Enhanced Services (DES) - must be provided by the PCT for its population, eg. the childhood immunisations programme
  • Local Enhanced Services (LES) - locally developed services designed to meet local health needs
  • National Enhanced Services (NES) - services commissioned to meet local need to national specifications and benchmark pricing. Other examples of NES are enhanced care of the homeless, more specialised services for multiple sclerosis and specialised care of patients with depression.

 Further details on the current range DESs and NESs can be found in the section on pre-ballot documents in the page:

The Primary Medical Services (Directed Enhanced Services) (England) Directions 2007

These Directions come into force on 3 August 2007. They require that each primary care trust must exercise its functions under section 83 of the National Health Service Act 2006 of providing primary medical services within its area, or securing their provision within its area, by (as part of its discharge of those functions) establishing (if it has not already done so), operating and, as appropriate, revising schemes as laid out in these Directions.

The Directions no longer contain the Information and Management and Technology or the Practice Based Commissioning DESs, these schemes only covered the financial year 2006/07.  Although where an IM&T DES was agreed in 2006/07 payments will continue to be made up until 31 March 2008.

Each Primary Care Trust must exercise its functions under Section 83 of the Act of providing primary medical services within its area, or securing their provision within its area (as part of the discharge of those functions), by establishing (if it has not already done so), operating and, as appropriate revising the following schemes for its area:-

· an Improved Access Scheme;
· a Choice and Booking Scheme;
· a Childhood Immunisation Scheme;
· an Influenza and Pneumocooccal Immunisation Scheme;
· a Violent Patients Scheme;
· a Minor Surgery Scheme.

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