Abstract
Answer A. Directed enhanced services (DESs)
Enhanced services that are nationally commissioned through the GP contract by NHS England and legally directed by the Secretary of State are known as directed enhanced services (DESs).
The general medical services (GMS) contract is a nationally directed contract between NHS England and a practice. The new GMS contract was introduced in April 2004.
The personal medical services (PMS) contract is a local contract agreed between NHS England and the practice, together with its funding arrangements.
British Medical Association (BMA) (2013) NHS contracts for primary medical services. Available at: www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/advice-for-dispensing-gps/the-gp-practice/nhs-contracts-for-primary-medical-services (accessed 20 April 2018).