Chair’s introduction
As the cooler and wetter weather closes in this Autumn, I suspect many of us are wistfully looking back at the Summer, perhaps choosing not to remember that many of us were complaining about the heat. The weather has always been a typical topic of conversation for people living in Britain, and I suspect that will always remain the same.
The weather in our General Practice environment has remained stormy and challenging. Colleagues across the profession have been finding things challenging, and perhaps even more so following the onslaught of FP69s affecting practices all over England, but particularly so in London. NHSE frames this as a way of ensuring the public purse is used wisely and that GPs are not claiming payment for ghost patients.
I am sure that the vast majority of GPs would agree that payment for non-existent patients is inappropriate, however the reality is that the FP69 process has become much more challenging and is disproportionately affecting practices with highly transient populations or high levels of deprivation, i.e. precisely those practices that desperately need stability and support.
Even in more affluent parts of London, the FP69s are having an impact on practice stability, with the threat looming that PCN payments will be based on January 2027 patient registration data. It is not surprising then that the FP69 issue will be keenly debated at the November Conference of England LMCs. On this occasion I will be unable to attend Conference, but I am sure that Dr Paul Alford, Merton LMC Vice Chair will represent us all effectively, with grace and wisdom.
In the last newsletter I expressed optimism that we are finally getting to the end of our Locally Commissioned Services negotiations with the ICB. Unfortunately, my optimism has proven to be misplaced as those negotiations again stalled over the summer, partly as a result of the ever-changing personnel situation at the ICB, but also because the issue of the significant underfunding of these services has been challenging for the ICB to address. I would note that Wandsworth colleagues are in a similar position.
I am happier to report that I have had discussions on a face-to-face basis with senior ICB colleagues, and I am hopeful that a resolution is to be had. Once we have more concrete information, we will share that with you.
Thank you again for reading to the end of this missive. I wish you all a pleasant Autumn, looking forward to the festive season and then the New Year.
Dr Marek Jarzembowski
Chair
Merton LMC
What is the LMC and what do we do?
- We are the representative body for General Practice that is recognised in statute and are the professional voice of General Practice at a local level.
- We are the only directly elected body representing all local GPs, regardless of their career position or employment status
- We consult with NHS bodies, Integrated Care Boards (ICBs) and local councils and any other potential commissioning bodies, negotiating local contract terms for General Practice
- The LMC works for and with individual GPs and practices, providing support through our knowledge of contracts, systems and stakeholders at all levels, including borough, ICB, regional and national.
- We inform and engage with workforce development, planning, education and training for all roles within General Practice.
- Merton LMC works closely with neighbouring LMCs in SW London, as well as with LMCs across London, under the umbrella of Londonwide LMCs.
Your LMC
Your Merton LMC committee members are listed below, and their term runs until 31 August 2028. If you need to speak to any of the LMC committee members about any issue impacting general practice, please contact them using the details below, or alternatively via: david.moore@lmc.org.uk.
- Dr Paul Alford (vice Chair), Morden Hall Medical Centre
- Dr Caroline Chill, Sessional
- Dr Elizabeth Higham, Central Medical Centre
- Dr Marek Jarzembowski (Chair), Sessional
- Dr Andrew Otley, Cricket Green Medical Practice
- Dr Elisabeth Wood, Morden Hall Medical Practice
- Dr Shailey Vora, Vineyard Hill Road Surgery
- Ms Alison Kirk (PM rep), Central Medical Centre
- Ms Lynsey Buckles (PM rep), Francis Grove Surgery
- Dr Melanie Coulson (VTS rep), Sessional
Londonwide’s LMC Team supporting Merton LMC:
- Dr Asiya Yunus, Medical Director, Asiya.yunus@lmc.org.uk
- Kate Hudson, Director of Primary Care, Kate.hudson@lmc.org.uk
- James Winstanley, Assitant Director of Primary Care, James.Winstanley@lmc.org.uk
- David Moore, Committee Liaison Executive, David.moore@lmc.org.uk
- Emma Smith, Committee Administrator, Emma.smith@lmc.org.uk
What has Merton LMC been working on recently?
Merton LMC regularly meet with senior representatives from the ICB, Federation and Public Health and below is a summary of our discussions over the last period:
Winter Funding: The winter-resilience plan submitted jointly by Merton and Wandsworth Federations has been provisionally signed off, but the start date has not been confirmed. The funding is an unchanged replication of last year’s amount, which is directed to the Federation rather than individual practices, and is intended to provide evening, weekend, and bank-holiday appointments from approximately December through February or March.
Community care and funding: The LMC discussed the Merton Alliance’s work to bring health, social care, the council and voluntary-sector partners together. An initial integrated neighbourhood team pilot in Morden will focus on frailty, with evaluation informing wider roll-out. Members stressed that moving care into the community must be matched by sustainable funding for general practice and early, meaningful involvement in service design. Concerns remain about locally commissioned services receiving no uplift for around ten years and the potential impact of service withdrawal.
Respiratory services: The respiratory optimisation pilot ended on 14 August 2026 when its funding expired, after 94% of offered appointments were booked. Its evaluation will be taken to the ICB and acute partners to support the case for a permanent, properly funded community pathway.
NHS Health Checks: Delivery is recovering following improvements to patient lists and invitations. Additional capped funding is expected from April 2027 to expand invitations and support approximately 5,000 completed checks annually. The Federation has proposed increasing payment from £25 to £32.50 per check, with additional support for training, marketing and point-of-care testing. Practice delivery remains the preferred model, with Federation hubs as a contingency where staffing limits capacity. Participation in the national online pilot remains paused while current delivery is prioritised.
The LMC working on your behalf
LMC engagement with proposed SWL/SEL Integrated Weight Management Pathway
SEL and SWL LMCs have been engaged in discussions with the ICB regarding the proposed integrated primary care weight management pathway. While supporting the aim of improving access to obesity services, LMCs remain concerned about contractual safety, clinical accountability, governance, data sharing, discharge arrangements and the potential transfer of unfunded workload and risk to general practice.
The ICB has shared revised proposals which do not resolve LMCs fundamental concerns, in fact they introduce further complexity, fragmentation and uncertainty, which leaves the LMCs unable to reassure practices that this is safe, equitable and sustainable work to undertake. Responsibility for resolving these issues rests with the ICBs and LMCs have advised the ICBs that they will be unable to engage further until they have received a revised, coherent and appropriately funded proposal.
SWL Tier 1 Chronic Kidney Disease (CKD) Identification, Monitoring and Management Service Specification (2026/27) as part of the SW London Cardio-Renal-Metabolic (CRM) Model
Londonwide LMCs have written to all GP practices across Merton, Wandsworth and Sutton regarding the above Tier 1 Service Specification, which can be found here.
Merton LMC representatives attend the following groups, to ensure that the voice of general practice is heard within the wider system debate.
- Locally Commissioned Services (LCS) Task & Finish group
- Frailty cohort discussion
- Provider Alliance
- Merton Provider Care Collaborative
- Merton Health and Together
- Merton & Wandsworth Clinical Quality Performance Delivery Group
- Merton & Wandsworth Clinical Oversight Group
- Merton & Wandsworth ICS Working group
- SGUH Quality Primary/Secondary care interface group
- Virtual ward, UCR and SDEC integration working group (Merton & Wandsworth)
Upcoming events
Next LMC conference
The next national conference will be the England LMC Conference, which will be held on 20 November in London. Dr Paul Alford, vice chair of Merton LMC, will be representing Merton at the conference.
Motions that have been submitted by LMCs across England are debated, and if passed, are then taken forward by GPCE when engaging with government. We will let constituents know what motions have been passed by conference in our next news update.
Other services that Londonwide LMCs provides on behalf of general practice across Merton
GP Support team
The General Practice Support team comprises non-medics (Vicky Ferlia, Jan Swannell, Jacqui Perfect, Yvonne Frank, Vanessa Douglas) and Medical Directors (Dr Elliott Singer, Dr Kirsa Morganti, Dr Sara Riley, Dr Lowri Kew).
The team operates at different levels providing confidential, tailor-made, expert advice and assistance to individual doctors, practices and PCNs in difficulty. They offer contractual support to our primary care teams. Feedback/responses to papers & briefings to LMC reps. Policy influence at London level e.g. NHSE/ICBs, CQC. Attendance at Performance Advisory Group (PAGs) and Performers Lists Decision Panels (PLDPs). General Practice support includes:
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PCN Support
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For help or support please contact the GP Support team at gpsupport@lmc.org.uk .
FP69 advocacy and information gathering
Londonwide LMCs have continued to raise the issues affecting London practices, including meeting with MPs, briefing journalists, speaking to the voluntary sector and gathering first-hand details from some of the hardest hit practices. Our most recent analysis of NHS data shows that London has lost over 315,000 registered patients between January and September.
If your practice has not recently updated us on how FP69 is impacting you please do so via this form or email us. To make the case for a change of approach we need individual figures and insights, alongside official statistics.
Get new deals with the Londonwide LMCs Buying Group
Our Buying Group suppliers not only offer great deals to practices looking to switch, they also aim to offer the best value to existing customers in the Londonwide LMCs area, including explaining new products and features as they get rolled out.
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