In respect of all four of these new Directed Enhanced Services, PCTs are directed to incorporate the arrangements into the contractor's primary medical services contract.
The Department maintains a standard GMS contract that PCTs are free to use. To help PCTs incorporate the new Directed Enhanced Services into this standard GMS contract the Department has prepared a standard variation document. Use of the standard draft is not mandatory but PCTs may wish to utilise its terms, which have been agreed with the GPC. PCTs should note that the incorporation of these changes into a GMS contract is to be treated as a variation by agreement and must be signed by, or on behalf of, the PCT and the contractor.