Enhanced services GP practices can seek funding for

Enhanced services are defined as primary medical services other than essential services, additional services or out-of-hours services. This page provides information about directed and local enhanced services in England.

Location: England
Audience: GPs Practice managers
Last reviewed: 19 April 2021
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Directed enhanced services

DESs (directed enhanced services) are nationally agreed and have to be offered to all GP practices in England. Practices can decide whether they sign up to a DES or not, but they must be offered the opportunity to do so.

The legislation underpinning these DESs is set out in the DES and the statement of financial entitlements directions. Any updates to DESs are announced with the outcomes of the national GP contract negotiations.


Local enhanced services

Local commissioners can develop LESs (local enhanced services) to offer to local practices to supplement services already offered in the core practice contract.

As LESs are not agreed nationally, they vary across the country in scope and funding. Practices can decide whether they sign up to a LES.

The following list shows examples of enhanced services that have been commissioned somewhere in the UK. This list is not exhaustive, but rather provides practices with an indication of the kinds of services that they may be able to seek funding for.

  • 24 hour ambulatory blood pressure monitoring
  • Ad hoc audit LES
  • Additional clinical services
  • Administration of gonadorelins for patients with carcinoma
  • Administration of PCV and hib/men C vaccinations
  • Administration of goserelin implant in general practice
  • Alcohol and substance misuse
  • Anticoagulation
  • Asylum seekers and refugees
  • Atrial fibrillation
  • Bank holiday working
  • Cardiovascular health checks
  • Care home support
  • Carers
  • Chlamydia screening
  • Choose and book
  • Complex leg ulcer treatment
  • Contraceptive device fittings, specifically 'implanon'
  • CVD risk assessment
  • Delivery of brief interventions to patients to reduce alcohol related harm
  • Denosumab
  • D-dimer / DVT management in the community to avoid hospital admissions
  • DMARDs under an effective shared care protocol
  • Domiciliary falls/minor injuries
  • DVT pathway contract
  • Ear syringing
  • ECG recording
  • Emergency box palliative care
  • Emergency treatment of minor injuries in general practice
  • Emergency hormonal contraception service
  • Extended hours
  • Flu immunisation
  • Glucose tolerance testing
  • GNHR (Zoladex/Prostap)
  • Gold therapy
  • Gonadorelin analogue treatment
  • Heart failure
  • Hip B catch up
  • HIV in primary care
  • Homeless patients
  • Infant hep B vaccination programme (post exposure immunisation)
  • Infectious disease immunisation
  • Insertion of contraceptive devices
  • Insulin initiation or conversion
  • Learning disabilities
  • Lithium
  • Mental health depression counselling service
  • Meningitis C vaccine for university entrants
  • MMR vaccinations provided to under 25 year olds
  • Minor injuries
  • Minor surgery
  • Near patient testing
  • Neonatal checks carried out by GPs
  • Nexplanon
  • Nursing homes
  • Nursing homes virtual ward scheme
  • Over 75 LES - med reviews and health check including house bound patients
  • Phlebotomy
  • Post-op suture removal
  • Pre and post op swabs/investigations
  • Primary care provision for patients who have had difficulty maintaining registrations and require frequent allocations
  • Primary care sexual health scheme
  • Primary preventions of coronary heart disease
  • Prostate cancer follow up
  • Provision of immediate and first response care
  • Provision of wound care and minor injuries service
  • Provision of wound care minor injuries
  • Referral review scheme
  • Ring pessary insertion
  • Rheumatology drugs
  • Screening of/vaccination/provision of prophylactic antibiotic or antiviral treatment and other services required for asymptomatic individuals or for outbreaks in institutions at the request of Public Health England
  • Secondary care generated bloods
  • Secondary care wound management
  • Shared care / specialist drug monitoring
  • Sigmoidoscopy
  • Smoking cessation programmes
  • Specialised primary care service for depression
  • Spirometry
  • Student health
  • Treatment room support
  • Treatment room/basket services
  • University students
  • Vaccination against hepatitis B
  • Vasectomy
  • Violent patients
  • Warfarin prescribing
  • Wound care
  • Wound care leg ulcers level 1
  • Wound care leg ulcers level 2 - pressure dressings (higher tariff than level 1)

If you are signed up to a LES that is not included in the above list, please pass on the details and we will add them.

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