Directed Enhanced Services (DESs)

NHS Employers and the General Practitioners Committee (GPC) agreed the following enhanced services changes for 2014/15.

  • The Patient Participation scheme will be extended for a further year with the requirement to carry out a local survey removed. This is due to the introduction of the Friends and Family Test.
  • The Extended Hours Access scheme will be extended for a further year with a number of flexibilities included to allow practices to work together to provide the most appropriate service for their patients.
  • The Dementia, Alcohol and Learning Disabilities will be extended for a further year with some changes made.
  • A new one year scheme for Avoiding Unplanned Admissions: proactive case finding and care review for vulnerable people – a programme of action for general practice and clinical commissioning groups. The Read2 and CTV3 codes for this service are included in the Technical requirements for 2014/15 contract changes document. This document has been updated to include further information to support this enhanced service.

The guidance to support the enhanced services for Patient Participation, Extended Hours, Dementia, Alcohol and Learning Disabilities is now available.

The new Avoiding Unplanned Admissions ES aims to:

  • provide timely telephone access, via ex-directory or bypass number, to relevant clinicians and providers to support decisions relating to hospital transfers or admissions, in order to reduce avoidable hospital admissions or A&E attendances
    proactively case manage vulnerable patients (both those with physical and mental health conditions) through developing, sharing and regularly reviewing personalised care plans, including identifying a named accountable GP and care coordinator
  • improve access to telephone or, where required, consultation appointments for patients identified in this service who have urgent enquiries
  • work with hospitals to review and improve hospital discharge processes, sharing relevant information and whole system commissioning action points to help inform commissioning decisions.
  • undertake internal reviews of unplanned admissions or readmissions or A&E attendances

Updated guidance and templates to support implementation of the Avoiding Unplanned Admissions enhanced service are now available. The NHS England enhanced service specification has now been published.