GMS Contract
.... website hosted by HOWIS 
GMS Contract GMS Contract

Enhanced Services

 Mental Health DES Specification - April 2013
 The Primary Medical Services (Directed Enhanced Services) (Wales) (Amendment) Directions 2013

 More information on the following document... The Primary Medical Services (Directed Enhanced Services) (Wales) (Amendment) Directions 2012

GMS Contract Agreement 2009/10
Swine Flu
GMS Contract Agreement 2008/09

 More information on the following document... 1. Directed Enhanced Service for 2008-09 Guidance
 More information on the following document... 2. Enhanced Service for Extended Surgery Opening Hours
PDF More information on the following document... 3. Enhanced Service for Asylum Seekers and Refugees
PDF More information on the following document... 4. Enhanced Service for Homeless Patients
PDF More information on the following document... 5. Enhanced Service for Care Homes
PDF More information on the following document... 6. Enhanced Service for Diabetes Care
(added 10th September 2008)

The new General Medical Services (GMS) contract was implemented in Wales in April 2004. It is funded through new funding streams for essential, additional and enhanced services, modernising infrastructure and the quality and outcomes framework.

Enhanced services are, in essence, elements of essential or additional services delivered to a higher specification, or medical services outside the normal scope of primary medical services, which are designed around the needs of the local population. Enhanced services are commissioned by Local Health Boards and can be contracted from any provider, not just GMS contractors, so long as the provider can meet the service specification and provide value for money. Enhanced services provide LHBs with opportunities to develop more local and integrated services across primary and secondary care. There are three categories of enhanced services:

  • Directed (DES) – all LHBs must commission or provide
  • National (NES) – all LHBs should commission or provide but not mandatory
  • Local (LES) – optional commissioning of services based on local needs

Enhanced services are funded from the LHB administered budget for the GMS contract. This is a ring-fenced allocation with a spending floor set by the UK Technical Steering Committee (TSC) for the GMS contract. The enhanced services floor is the minimum amount that must be spent on enhanced services although LHBs are free to spend more using other funding streams as appropriate.

Practices wishing to enquire about providing Enhanced Services should approach their LHB in the first instance.


 LHB Enhanced Services Guidance

 Learning Disability Service Principles and Responses 

 Guidance on Enhanced Services 04/05

Documents Issued December 2007

2006/07 Access to GMS - Patient Experience Survey

LES Specifications & Supporting Documents

NES Specifications & Supporting Documents

Other DES Specifications & Supporting Documents

Last updated: 17/06/2013