Enhanced services 2008/09

Student nurse caring

Five new clinical DESs

  • Heart Failure DES - improving the treatment of heart failure and including incentives to provide beta-blockers to appropriate patients. Practices get £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 get £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 get £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 is £588.21
  • Ethnicity DES - rewarding practices for recording the ethnicity and first language of all the patients on their practice list. Practices get 5.6p per registered patient

We published supporting FAQs on these clinical  DESs.

Extended Opening Hours 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.


  • 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.

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