Directed enhanced service
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- Local enhanced services (LESs) – schemes agreed by PCTs in response to local needs and priorities, sometimes adopting national service specifications. *Directed enhanced services (DESs) - schemes that PCTs are required to establish or to offer contractors the opportunity to provide, linked to national priorities and agreements.
When the Department of Health (England) agrees that a service must be provided, it may introduce a "Directed Enhanced Service" (DES - note not "Directly Enhanced Service"), requiring Primary Care Trusts to pay a specified fee to e.g. GPs for the service.
In contrast a Local Enhanced Service (LES) has to be paid for out of PCT funds.
Prior to the introudction of the NHS Commissioning Board national directions currently cover eight DES schemes:
- childhood immunisation
- influenza and pneumococcal
- violent patients
- minor surgery
- extended access
- alcohol reduction
- health checks for people with learning disabilities
- patient participation.
This will all change when the NHS Commissioning Board comes into existence. The guidance about the 2012 UK antenatal pertussis vaccination campaign, for example, refers to a "National Enhanced Service" (NES).