Enhanced Services (ES) are services or activities provided by GP practices that have been negotiated nationally and at an enhanced service level above what is required by the core General Medical Services (GMS) contract. ES are primary medical services other than essential services, additional services or out-of-hours services. ES encourage practices to ensure patients receive the best care and service provision in primary care under categories deemed as national priorities for health, ensuring practices work to similar high standards.

There are two types of ES: Directed Enhanced Services (DES), which are nationally agreed and must be offered to all GP practices in England, which practices can opt to sign up to. Local commissioners can also develop local enhanced services (LES) to offer to local practices, which complement services already contained in the core GP contract.

Under the 2022 Health and Care Act, Integrated Care Systems (ICSs) were formalised as legal entities with statutory powers and responsibilities, subsuming Clinical Commissioning Groups (CCGs). ICS comprise of two key components, integrated care boards (ICBs), statutory bodies responsible for planning and funding most NHS services, and Integrated care partnerships (ICPs) where statutory committees bring together system partners to develop a health and care strategy for the geographical area.

Contractors involved in ES need to ensure they fully understand the service specifications and requirements. ES may be contracted from any provider, not just GMS contractors. Providers must meet the service specification and provide quality and value for money. Practices can choose whether to provide these services. Once an ES has been implemented by a practice, they are entitled to financial remuneration.

This topic covers various services and their aims, implementation and monitoring.

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