The areas of the contract which had been under negotiations related to the Extended Hours Access Scheme Directed Enhanced Service (DES), first introduced in 2008/09 and four clinical DESs in England.

The Extended Hours Access Scheme DES rewards GP practices for providing around three hours extra appointment time per average practice a week, at times that suit the needs of their patients. It has now been agreed that this DES will be extended for a further year for 2010/11. Practices will now need to confirm with their PCT whether they want to take up the DES.

In addition, NHS Employers and the General Practitioners’ Committee agreed to extend the four clinical DESs in England for a further year, based on the existing 2009/10 thresholds.

The four clinical DESs are:

• Alcohol DES – helping to reduce the risk of adults, aged 16 years or over, drinking at ‘increasing, higher risk or dependent’ levels defined by the World Health Organisation. Practises are rewarded based on cases identified  in newly registered patients aged 16 and over.

• 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.

• Osteoporosis DES – encouraging practices to diagnose and prescribe appropriate pharmacological secondary prevention for patients with osteoporosis. Payments will be based on three criteria covering diagnosis and treatment.

• Ethnicity DES – rewarding practices for recording the ethnicity and first language of all the patients on their practice list.

On reaching a final agreement with the GPC Andrew Clapperton, Head of Primary Care Workforce and Contracting at NHS Employers, said: “I am pleased that we have been able to conclude our negotiations on these important areas of the contract in a timely way and to the satisfaction of all parties. The new contract continues to provide practices with the foundations on which they can continue to deliver outstanding services to the communities they serve.”

Dr Laurence Buckman, Chairman of the GPC, said: "With the conclusion of these negotiations I hope GPs will be pleased that there will be a year of relative stability in the arrangements for the delivery of services to patients."

The Department of Health are in the process of drafting the Directions for the Clinical and Extended Hours Access Scheme DESs, and are also working on the accompanying Extended Hours Guidance. NHS Employers will be publishing an updated version of the clinical DES guidance shortly. In the interim, PCTs can use the existing guidance which will largely remain unchanged