This information is not available centrally. We are however monitoring primary care trusts' spend on this directed enhanced service and have commissioned an independent survey of activity, by general practitioner practices, on this directed enhanced service. Both data sources suggest that since this directed enhanced service was introduced the number of health checks given to patients with learning disabilities has increased significantly, with overall expenditure expected to almost double from £6 million in 2008-09 to over £11 million in 2009-10.