Directed Enhanced Services (DES) are nationally negotiated services, which are over and above those provided under GMS/PMS/APMS contracts, which the ICB (delegated by NHSE) are obliged to commission.
Please see NHS England » GP Contract
Directed Enhanced Services
- Network Contract (PCN) – Documents covering this DES and can found on NHSE website. See also Wessex LMC Contract update.
- Learning Disability Health Check
- Violent Patients Scheme (Special Allocation Service)
- Minor Surgery Scheme
The details for these can be found in the Primary Medical Services (Directed Enhanced Services) Directions – GOV.UK
Finance details can be found in the Statement of Financial Entitlements Directions.
Covid-19 and Seasonal Flu
This enhanced service specification covers both the COVID-19 and adult influenza vaccination services from 1 April 2026 to 31 March 2027. Please visit the Wessex LMCs flu pages each year for full details. Seasonal Flu and COVID
Locally Commissioned Services (LCS)
- These are schemes designed to meet local needs (and are sometimes referred to as Local Enhanced Services – LES)
- They are optional for Practices to provide
- The ICB will usually consult with the LMC before they are issued, and we try to secure the best terms. It is an individual Practice decision to decide whether they want to sign up
- The BMA list a number of these services on their website that they are aware of around the country.
Enhanced Services and Contracts – what are these and what influence do these have on the nursing team?
Lunch and Learn Package:
The GP contracts that the practices sign up to affect everything we do in the surgery, and the Locally Commissioned Services affect which services and treatments we offer our patients. This Lunch and Learn resource provides a really useful overview of all GP Contracts which will be informative for every member of staff, especially anyone new to joining the nursing team. It will enable the nursing team to enhance their understanding of which services they are able to offer patients and why these might change. The importance of accurate coding is also highlighted to ensure that the practice is paid for the important care that their clinicians are offering.
If you have ever wondered how the finances work in general practice and how your particular job in the treatment room affects these, this is the presentation for you and your team!
Purchase the Lunch & Learn Package here
Podcast:
Contracts underpin all we do in the practice – including care in the treatment room. Lisa Harding (Director of Primary Care) & Zoe Tobin (previous Nurse Advisor) talk to Louise Greenwood (Director of Education & Training) about the importance to the nursing team of understanding how the contracts work. The contracts can affect the treatment that the nursing team give, the equipment that they use and the education that they need. And this understanding can assist in conversations with patients. Do listen to find out more and share with all members of the nursing team.
Listen to the podcast here
