Dear colleague,
North Central London LMCs newsletter – June 2025
Over the last month Londonwide LMCs NCL Sector Team have supported borough level LMCs focusing on the following areas that have impacted and continue to impact all five boroughs of NCL.
Londonwide LMCs guidance in focus
Shared care guidelines are frequently used in the NHS to transfer work and the care of patients from secondary/tertiary care to primary care. The Londonwide LMC’s guidance which forms part of the safe working pack can be accessed here.
Integrated Neighbourhood Teams (INTs)
NCL ICB are putting in place plans in response to the government focus on neighbourhood health. NCL LMCs have continued to push for the need to have clear and transparent communications from the ICB to practices. What we know so far:
- 18 proposed INT sites across NCL; boundaries were agreed by borough colleagues and Borough Partnerships.
- Some reflect existing localities, but size and geography are variable.
- A number of INTs reflect the high levels of deprivation across the five boroughs.
- ICB focus is on the wider determinants of health and the rising levels of patient risk and complexity that requires a multi-agency approach to the INT model.
- NCL and the individual boroughs will be expected to appoint an INT Integrator via the Borough Partnerships, although there is no additional funding to support this role.
NCL LMCs were represented at a system event on 13 June which focused on:
- Outline of the vision for neighbourhoods across North Central London.
- Strengthening cross-borough collaboration to support the development of neighbourhoods.
- Sharing progress, challenges, and learning from existing models.
- Discussing next steps as a system.
Broadly speaking there was agreement from those attending that the NCL model presented was heading in the right direction. Further events are being planned at a borough level throughout July. We will keep you updated as more information and INT plans become available.
ADHD Services and Shared Care
LMC representatives from all five boroughs continue to meet with staff from across the mental health trust in NCL monthly. The focus of discussions in the June meeting were on the commissioning gaps and shared care arrangements (SCA) for ADHD patients. LMCs have reinforced the messages that shared care arrangements need to be safe for patients, provide easy access for GPs to discuss cases with a consultant and for the Trust to maintain responsibility for complex cases. The message was reinforced by LMCs that there is a significant difference between a GP undertaking an annual review of a patient’s bloods, weight and blood pressure in comparison to a full SCA annual review as specified by NICE guidance. It was made clear to the Trust and the ICB that whilst some GPs with a specialist interest may wish to undertake full annual reviews, GPs should not be expected to pick up this work where is lies outside of their area of skills and competencies. The ICB has started initial discussions to scope an LCS, we will continue to monitor this and bring updates as they become available. If you are experiencing an issue with ADHD patient care or have another aspect of mental health that you wish the LMCs to raise at the interface meeting please either contact your LMC Chair or email joni.wilson-kaye@lmc.org.uk.
GLP1 – Prescribing in Primary Care for Weight Management
LMC representatives met with Hannah Logan, Public Health Consultant and Louise Coughlan, Chief Pharmacist from NCL ICB to discuss the ICB’s plans for setting up a pathway for Tirzepatide for weight management. The ICB is working on developing a single point of access (SPoA) model for patients who meet the criteria.
It is obvious that much thought has gone into the model design and subsequent proposals, sensitive to existing system demands. With the start date for the service socialised as 23 June 2025, please see our e-alert , circulated to all GPs/Practices 24 June, and which includes links to the BMA Guidance as well as the latest ICB communications and NCL ICB website update.
SDEC and the proposal to standardise follow-up period to one week
LMCs have been expressing concerns to NCL ICB about NHS London Regional Team’s decision to standardise the follow-up period from Same Day Emergency Care (SDEC) to one week. Currently there is no data available for the individual trust sites and therefore across NCL regarding the numbers of patients being seen within SDEC so we cannot assess the possible impact to general practice. There is also considerable variance both in timeliness and scope of the discharge summary and care plan that should accompany the patient at the time of SDEC discharge and which could impact impact patient safety.
SDEC was set up to relieve pressure on ED and allow capacity for elective care, but what it is not for is for GP to do, and for GPs to complete the work of SDEC. As a consensus, and because of our overriding concerns for patient safety and capacity issues, we do not agree with the decision to the decreases in SDEC discharge timings and will continue to raise concerns with the ICB.
Primary/ Secondary Care Interface
LMC leads have been raising a wide number of interface issues at the NCL Interface Steering Group, Pathways Group and also at the Referral Interface Group. GPs are represented by LMC members at all four Trust interface meetings (Royal Free, UCLH, Whittington Health and North Middlesex University Hospital Trust). Specific LMC input is taking place on the plans to develop an NCL wide ENT pathway.
Please email sarah.ocran@lmc.org.uk with any borough specific interface issues so that our LMC reps can raise them on your behalf at the trust interface meetings. You can also contact GP liaison at the relevant trust using the following email addresses:
- Royal Free Hospital: rf-tr.gpliaison@nhs.net
- University College Hospital: UCLH.gpqueries@nhs.net
- Whittington Hospital: whh-tr.gpqueries@nhs.net
- North Middlesex University Hospital: northmid.gpliaison@nhs.net
LMC election nominations
Thank you to everyone who nominated themselves for their LMC. The nomination period ended on 3 June. Please note the following key dates:
- Monday 23 June – Voting papers issued/Declaration of results from those constituencies elected without a ballot.
- Tuesday 22 July 2025, 12.00 pm – Close of voting.
- Monday 28 July 2025 – Publication of results.
The Londonwide LMC NCL Sector Team
You can find the details of your LMC Chairs across NCL here. If you have any specific concerns arising about this or any other issue, please contact us via joni.wilson-kaye@lmc.org.uk.
Best wishes,
The NCL Londonwide LMC team:
Jamie Wright, Director Primary Care,
Vicky Weeks, Medical Director,
Joni Wilson-Kaye, Assistant Director Primary Care – joni.wilson-kaye@lmc.org.uk ,
Sarah Ocran, Committee Liaison Executive – sarah.ocran@lmc.org.uk