Dear colleague,
North West London LMCs newsletter – July 2025
Londonwide LMCs guidance in focus
Tirzepatide/Mounjaro messaging
From 23 June 2025 NHS England guidance on Tirzepatide (Mounjaro) stipulates that it must be implemented in primary care. This implementation can be via general practice, federations, or community specialist clinics. We have written to practices with the GPC guidance, which includes a template letter for practices to respond to requests for medical information following a private consultation.
There is currently no service in NWL practices and no supporting wraparound service, but CDs have raised with us that practices are receiving high numbers of calls and contacts from patients following national publicity. We met with the ICB and raised the need for a comprehensive communication strategy for practices, patients and patient groups and agreement of a clear pathway with supporting resources to reduce this burden on practices. In the interim, details are here on Tirzepatide and the NHS in North West London: North West London ICS.
Updated national FAQs on online consultations
Following further discussions with suppliers, NHSE and the profession, GPC England (GPCE) has updated its FAQs on online consultations ahead of the implementation of contractual requirements in October. GPCE expects to update these FAQs again in August to reflect ongoing discussions.
This month, your LMC has been discussing the following
NWL ICB’s strategic landscape: possible changes ahead
Following last month’s report that ICBs have been tasked with reducing their running costs by 50%, NCL ICB and NWL ICBs’ next public board meetings on 22 and 23 July 2025 respectively will be considering a business case and options appraisal on whether merging their organisations would be viable and in the interests of their local populations and providers. Should this be agreed, NHS England would expect any merger to be completed by April 2026, or April 2027 at the very latest. Discussions are at very early stages and we will keep you updated.
Primary Care Provider Collaborative Development
Your LMCs attended an event on 18 June where NWL ICB launched the establishment of a NWL Primary Care Collaborative. Representatives from general practice across all 8 boroughs attended alongside colleagues from dentistry, optometry and community pharmacy. In the coming weeks the LMC will be involved in the task and finish group to progress the development of the collaborative including structure and function(s). We will keep you updated on progress.
ARRS payment problems
We have written to the ICB to raise the new delays, rejections and inaccurate payment problems Federations, CDs and PCN lead practices have sent to the LMC. The ICB is talking to PCSE, calling all affected PCNs and exploring the feasibility of a quality improvement audit to identify areas of improvement in the payment process and avoid future problems. The ICB is also raising the need to speed up payment processing times with PCSE. £4M worth of claims were processed in June and two payment runs have been set up for July to clear a further £2.4M. The ICB thanked PCN leads for their cooperation in resubmitting and correcting claims.
NWL ICB Enhanced Services Single Offer
2024/25
Year end reconciliation – in general, achievement and spend has been above plan. The MOES achievement and prescribing quality have improved, raising the NWL place in national benchmarking.
2025/26
The LMC raised the following with the ICB:
- Warfarin monitoring and funding – the ICB is exploring the reasons behind falling activity including the tariff as spotlit by the LMC and possible training needs.
- Diabetes – the ICB will be considering adjustments to HBA1c targets including exclusions for frailty, age, recent diagnoses and active dissensions. Following practices upskilling themselves, the LMC and ICB are working on a competency guideline for practices no longer needing to hold MDTs.
- MOES –25/26 budgets have been uplifted by 2.5%. The LMC has requested dashboards and data urgently to support practice and PCN planning and will be meeting with the team to discuss issues around acute trusts and pouches.
- Wound care – following community rejections of referrals for temporarily housebound patients (eg post-operative) the ICB will discuss their management with community trusts and explore a domiciliary tariff in the current single offer spec.
- Access service – following LMC concerns re the prerequisites around eg online consultation, the ICB has sent out a caveat to the self-declaration form. In response to LMC and PCN communications re the request to publish access improvement plans, the ICB clarified its ask for PCN’s and member practices to publish a patient-friendly summary on their websites by 21 July.
NWL (Imperial) Path Lab issues
LMC leads have raised the following:
- Unreliability of results.
- Poor communication.
- Need for quality assurance and monitoring mechanisms at the lab.
- Need for external monitoring including a user group with LMC involvement.
- GP compensation for the earlier uACR error-related work.
The ICB shares the LMC concerns, is considering evidence sent in, and is discussing the need for external quality assurance. We will keep you updated.
Best wishes,
North West London LMC Chairs