This page has details of the agreed DES changes for the General Medical Services (GMS) contract for the following years:
DES changes for 2010/11
NHS Employers and the General Practitioners Committee (GPC) agreed the following DES changes for 2010/11:
Extended Hours Access DES
- Continue existing arrangements for the Extended Hours Access Scheme DES until 31 March 2011. This DES was first introduced in 2008/09 and extended for 2009/10. However, for 2010/11 practices needed to confirm with their PCT by 30 June 2010 whether they wanted to take up this DES.
- Practices are rewarded for providing around three hours extra appointment time per average practice a week, at times that suit the needs of their patients.
Clinical DESs
- Extend the four clinical DESs in England (alcohol, learning disabilities, osteoporosis and ethnicity) for a further year until 31 March 2011.
Supporting guidance for 2010/11
The Department of Health published the Directions for the Clinical and Extended Hours Access Scheme DESs and the accompanying extended hours guidance. NHS Employers also published an updated version of the clinical DES guidance.
DES changes for 2009/10
NHS Employers and the GPC agreed the following changes for 2009/10:
- Moved the heart failure DES, introduced in 2008/09, to form part of the Quality and Outcomes Framework (see our QOF web pages)
- The remaining four clinical two-year DESs, introduced in 2008/09 (alcohol, learning disabilities, osteoporosis and ethnicity), continued until 31 March 2010.
- The Extended Opening Hours Access DES (introduced in 2008/09) also continued until 31 March 2010.
DES changes for 2008/09
The following three DESs covering new clinical areas, extended opening hours and information management and technology (IMT), were all introduced for 2008/09.
Five new clinical DESs:
- Heart Failure DES - improving the treatment of heart failure and including incentives to provide beta-blockers to appropriate patients. Practices got £35 per patient treated under this DES.
- Alcohol DES - helping to reduce the risk of adults, aged 16 years or over, drinking at 'hazardous and harmful levels' defined by the World Health Organisation. Practices got £2.33 for each new registered patient that has been screened.
- Learning Disabilities DES - annual health checks for people on the local authority learning disability register. To participate in this DES, practices need to attend a multi professional education session run by their PCT. Practices got £100 for every health check.
- Osteoporosis DES - encouraging practices to diagnose and prescribe appropriate pharmacological secondary prevention for patients with osteoporosis. Payments are based on three criteria covering diagnoses and treatment. The payment per average practice that meets all three criteria was £588.21
- Ethnicity DES - rewarding practices for recording the ethnicity and first language of all the patients on their practice list. Practices got 5.6p per registered patient
We published supporting FAQs on these clinical DESs.
Extended Opening Hours Access DES:
- Practices are rewarded for providing around three hours extra appointment time per average practice a week, at times that suit the needs of their patients. Practices were paid £2.95 per registered patient. The Department of Health issued more detailed guidance to PCTs.
IM&T DES:
- Practice eligibility to receive one-off payments continued for England for 2008/09 (rolled over from 2007/08). The Department of Health amended the Statement of Financial Entitlements to allow PCTs to make payments until 31 March 2009.
Supporting guidance for 2008/09
The original detailed guidance for 2008/09 has since been updated to support implementation of the clinical DESs and now includes information on audit requirements and coding.
You can find more details on the inflationary uplift and Access DES on the Department of Health's website.