Dear colleague,
North West London LMCs newsletter – September 2025
Londonwide LMCs’ guidance re GP contract changes
Londonwide LMCs’ summary of the full range of contract changes can be found here.
NCL & NWL ICB Merger
Following Board approval, NCL and NWL ICBs will merge in April 2026. A joint programme team is in place, with implementation plans to be reviewed at the 29 October public board meeting. Mike Bell has been appointed as joint Chair, and Frances O’Callaghan as joint CEO – the new name for the merged organisation has been confirmed as West and North London Integrated Care Board. The NCL and NWL LMC Strategic Leadership Network (SLN), covering 13 boroughs, meets quarterly to support the transition.
Primary Care Provider Collaborative (PCPC)
Development of the NWL PCPC is progressing rapidly, aligned with national directives to streamline ICB functions and reduce costs. The working group—comprising LMC SLN members and GPs from all 8 boroughs—is finalising the PCPC Board structure. The LMC continues to seek clarity on the transfer of ICB functions and welcomes feedback to shape discussions.
Enhanced Services – NWL ICB Single Offer
The Single Offer has been extended for two years from April 2026, allowing practices and PCNs to build on current successes.
2024/25 Year-End
Most reconciliation and appeals are resolved. The LMC is supporting a few PCNs with outstanding issues expected to conclude shortly.
2025/26 Developments
- Clinical Audit Templates: The ICB has adopted a flexible approach, incorporating LMC feedback. PCNs are actively engaging, and queries are being logged for continuous improvement.
- Warfarin Service: Concerns over affordability persist. The LMC has requested budget methodology and a dedicated meeting.
- Diabetes Payments: The ICB did not apply inflationary uplift to NDH and Level 1 services, citing spec changes. The LMC disagrees and has requested greater transparency.
- Spirometry: The LMC has asked the ICB to review activity data post-QOF changes to identify potential underspend.
- Wound Care: A service gap for temporarily housebound patients has been identified. The ICB is tracking activity and will escalate concerns.
- Tirzepatide (Mounjaro): The ICB is investigating reports of rejected GP referrals by commissioned trusts.
- Uncommissioned Services: The LMC has requested consideration of the following for 2025/26:
- Eating disorder pathway
- Inclisiran
- ADHD
- Transgender prescribing
- Frailty
The ICB will engage with the LMC on commissioning intentions and contract variations.
2026/27 Planning
The LMC has submitted research to support equitable service design. The ICB is exploring outcome-based approaches for cardio-renal-metabolic (CRM) care and hypertension case finding. A joint working group will be established to co-develop new schemes and avoid delays.
Windows 11 Upgrade
The LMC believes this GPIT issue should be resourced by the ICB. While no resources are currently available, the ICB may offer support if funding emerges. The LMC has requested data to explore reinvestment of potential underspends and fallback IT options.
Pathology Services Quality & Safety
LMC leads are engaging with the ICB on governance and quality assurance across NWL Path Labs. Compensation requests for GP work related to the Imperial uACR error were declined.
Primary–Secondary Care Interface
Despite NHSE-mandated Trust self-assessments, improvements are not yet evident in primary care. Key issues remain: missing contact details, hospital fit notes, and rejected referrals.
Best wishes,
North West London LMC Chairs