Enhanced services 2011/12

Doctors talking

 Extended Hours Access DES

The NHS Employers organisation and the General Practitioners Committee (GPC) agreed the following Directed Enhanced Services changes for 2011/12. These apply in England only.

This DES was extended by one year (to 31 March 2012). The following detailed requirements which applied for 2011/12 were reduced, to secure a reduction in the cost of this DES: 

  • during extended opening hours appointments may be offered by any healthcare professional, rather than GPs only;
  • the current restriction on concurrent working during extended opening hours will be removed;
  • urgent as well as routine care patients can be seen;
  • the minimum continuous period of extended opening will be reduced from one and a half hours to 30 minutes.

GPC and NHS Employers negotiators also agreed to reduce the payment per registered patient from £3.01 to £1.90. 

The Department of Health published the revised Extended Hours guidance on their website.

Clinical DESs

The Ethnicity and First Language DES is no longer be available from 1 April 2011.  This DES was intended as a two-year catch up to enable practices to record ethnicity and first language for patients already on their list.  Following the third year extension for 2010/11 this has now ceased.  GPC and NHS Employers negotiators expect all practices to record patients’ ethnicity and first language as a matter of routine in order to be able to demonstrate that practices continue to meet the health needs of their registered population.

The following existing clinical DESs were extended for the twelve-month period ending on 31 March 2012:

  • the alcohol reduction scheme;
  • the learning disabilities health check scheme, and 
  • the osteoporosis diagnosis and prevention scheme. 

The requirements of these three clinical DESs remain the same and the payment scheme mirror the payment scheme at the same rate that applied for the period 1 April 2010 to 31 March 2011.

For more information see the updated Clinical DES guidance 2011/12. This guidance has now been superseded by the 2012/13 guidance. To read the guidance please click here.

Patient Participation DES

The monies released through the reduction in the cost of the extended hours DES was reinvested into an initiative that seeks to improve patient participation and make GP practices more responsive to the needs and wishes of patients.

The Patient Participation DES aims to promote the proactive engagement of patients through the use of effective Patient Reference Groups (PRGs) and to seek views from practice patients through the use of a local patient survey.

The key requirements of the patient participation arrangements agreed by negotiators were that GP practices would:

  • develop a structure that gained views of patients and enabled the practice to obtain feedback from the practice population, e.g. PRG;
  • agree areas of priority with their PRG;
  • collate patient views through the use of a patient survey;
  • provide the PRG with an opportunity to discuss survey findings and reach agreement with the PRG on changes to services;
  • agree action plan with PRG and seek PRG agreement to implementing changes;
  • publicise the actions taken and subsequent achievement.

Around £60m of released investment was made available to practices, provided that they successfully met these requirements (equivalent in total to £1.10 per registered patient per year).

In developing this DES the GPC and NHS Employers agreed that the following statements provide a context within which GP practices should operate and which recognise the changing workload which would be expected of a modern practice:

A good GP practice will aim to offer excellent access into the practice, and also from the practice to other services in its role as coordinator of care, facilitating access to other health and social care providers.

Access has many dimensions; the relative importance of these vary according to the specific needs of the registered population.  These dimensions include:

  • Lists being open to all without discrimination
  • Hours of opening with the ability to be seen urgently when clinically necessary, as well as the ability to book ahead.
  • Continuity of care.
  • Range of skills available – access to different professionals.
  • A choice of modes of contact which currently includes face-to-face, phone and electronic contact but can be developed further as technology allows.
  • Geographical access, enabling care as close to home as possible.

Access must be flexible enough to meet the varying needs of individuals and requires sufficient capacity to meet the population’s needs. Details of access arrangements (including opening hours) should be made widely available to the population to enable patients to exercise choice.

Practices might find the following resources useful when developing their Patient Participation DES:

  • The Picker Institute: Invest in Engagement website - a comprehensive review of the best worldwide evidence of what works to engage patients and the public in healthcare
  • NHS Evidence: Patient and public involvement website - a specialist collection of NHS evidence on patient and public involvement.

Read the Patient Participation DES guidance and FAQs.

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