More work needed on DESs elsewhere in UK

Directed enhanced services (DESs) for Wales, Scotland and Northern Ireland have still not been finalised, according to the guidance on quality framework changes and enhanced services released this week.

GPC Wales chairman Dr Andrew Dearden confirmed that Wales would have four new DESs, including one on access.

Under the access DES for Wales, practices will be paid for patients simply completing access questionnaires, whereas in England payment will depend on the questionnaire results.

Enhanced services in IT and health checks for patients with learning disabilities are close to agreement, while a mental health service is still being considered in Wales.

Four clinical DESs are being negotiated in Scotland and the 50 points for access, currently included in the quality framework, will be 'rebadged' as an access DES.

The four DESs will cover unmet patient need in cardiovascular care, learning disabilities, improved liaison with carers and ensuring cancer referrals are seen quickly (GP, 17 February).

In Northern Ireland the four regional health boards have yet to agree what DESs they will commission but access and chronic disease management will be included.

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