Enhanced services 2014/15

Eye test

27 / 6 / 2014

This page outlines the enhanced services changes for 2014/15.

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 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

Find the following Avoiding Unplanned Admissions templates below:

Alcohol related risk reduction scheme

In the guidance for the alcohol-related risk reduction scheme enhanced service it says “mental health services may decline referrals until the patient's alcohol problems have been appropriately addressed”. What if the patient would benefit from such an intervention? 

In severe cases of anxiety or depression, consideration should be given to referring the patient to specialist mental health services. Patients whose AUDIT score indicates that they are drinking at increasing or higher-risk (scoring eight to 19), should not be denied access to practice based, or specialist mental health services if these services are clinically indicated and the patient would benefit from this intervention. However, it is recognised that specialised mental health services may decline referrals of alcohol dependent patients (those with an AUDIT score of 20 or above who have been clinically assessed as dependent) until the patient's alcohol problems have been appropriately addressed. Where this is the case, referral should be kept under review whilst the patient's alcohol dependency is being dealt with, until such a time as the mental health team will be able to accept the referral. It is recognised that this depends on appropriate and accessible services.

It has been agreed that the Patient Online (£24m) and Remote Care Monitoring (£12m) ESs will cease on 31 March 2014 and the associated GMS funding reinvested into core funding. 

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

Separate 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. 


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