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Enhanced Services Payments - Questionnaire results - December 2007

This analysis has been carried out at the request of a number of Practice Managers who wanted to be able to compare the amount they receive from their Primary Care Organisation for certain enhanced services with those payable in other areas.

A total of 98 respondents completed the questionnaire during October and November 2007.

When Directed and National Enhanced Services were first introduced, the Department of Health and the General Practitioners Committee agreed benchmark fees for the services to be provided and PCOs were informed that these fees must be paid. However, in 2006 the DH relaxed the rules and PCOs were able to offer whatever fees they wished or in many cases whatever they could afford for enhanced services. As a result it is amazing how many different Local Enhanced Services have been set up around the UK and the wide variation in levels of payments. It has also been noted from the results that although the DES and NES payments started in 2004/5, some PCOs appear to have kept the fees at the start-up level whereas others have increased by annual uplifts – what started out as a “national” fee has rapidly become a locally negotiated or perhaps more likely imposed fee.

The results analysis lists the type of enhanced service, the lowest and the highest fees reported and the average or most common fees paid.

We have also been sent details of a number of 'baskets of fees' paid for a variety of services (rather than individual enhanced services) and some of these examples are listed below:

Basket A - Non Core treatment room procedures - pre-audiology checks, Removal of sutures (ROS), dressings, implants, and extended services of phlebotomist / HCA £8748 pa

Basket B - Treatment room basket Secondary Care ROS, Post surgical dressings, ear syringing, NHS fertility £5 per procedure (notional 15 minutes)

Basket C - Phlebotomy, Suture removal & dyspepsia management - 37p per capita pa

Basket D - Patient transport, amber drugs, PCO activity reports, post operative wound care, leg ulcers, ear syringing, ad hoc - £5000 pa per average practice of 5891 patients

Two examples of possible LES payments for Access (Extended hours) have been given in the report – it is early days for these and as we become aware of any other PCO schemes, we will update the website.

Click here to open the Results Analysis (this is an Excel spreadsheet which open in a new window, close that window to return here)

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