North West London LMCs newsletter – June 2025
Londonwide LMCs guidance in focus
GP Support Team
The GP Support team provides expert, confidential and bespoke advice and support to individual constituent GPs and practices in difficulties. If you want to understand what this covers, please visit our website and the GP Support team section.
Contact: GPSupport@lmc.org.uk
This month, your LMC has been discussing the following.
ICB blueprint and possible transfer of ICB functions
ICBs are required to produce cost reduction plans by 30 May 2025 to their regional leads and consider which functions will
- Grow: functions for ICBs to grow / invest in over time to deliver against objectives
- Selectively retain and adapt: functions for ICBs to retain and adapt including by delivering at scale
- Review for transfer: functions and activities for ICBs to transfer over time
The ICB has given reassurance that the 50% reductions are in ICB running costs, not already agreed provider budgets such as the single offer. Any conversations regarding the transfer of functions will be inclusive of the LMC. Discussions are at very early stages and we will keep you updated.
Integrated Neighbourhood Teams (INT) development
Londonwide LMCs’ new CEO Lisa Harrod-Rothwell is in discussion with the regional team at a London level; at a NWL level, your LMCs are monitoring progress in boroughs, considering who is taking on the integrator/leadership roles, and any impact on the interface between general practice and other stakeholders such as Community Services, acute Trusts and Councils.
Primary Care Provider Collaborative development
Your LMCs will be sending representation to the workshop on 18 June and will be asking that proposals are fully inclusive of the GP and practice team voice.
NWL GP action on MAR charts
BMA and legal guidance is that there is no need for a GP to complete a community drug chart (MAR chart) as a prescription is all that is legally required for a nurse or other community worker to administer medication. MAR charts are a record of administration and not an authority to administer medication.
The prescription (FP10) serves as the necessary authorisation, and the GP is not obligated to provide an additional authorisation document. Following requests from GPs, NWL LMCs have written to Trust SROs, cc the ICB, giving 90 days’ notice from 17 April 2025 that GPs will no longer be providing medicine authorisation charts for district nurses.
The ICB has set up a Task and Finish Group including LMC representation to finalise processes regarding MAR charts before GPs stop this work, in particular palliative care.
Advice and Guidance (A&G) DES
Your LMCs have met with the ICB to discuss the management of this work including the cap, and is part of working groups looking at digital support for this work. LMC Chairs have requested the re-enablement of Advice and Guidance in e-RS, and e-RS portals.
Community Services Review
The LMC will be meeting with leads to discuss the proposed services, clarify ways of working and potential impacts, and correct any unrealistic expectations of General Practice.
ARRS payment problems
After having previously rectified issues, your LMCs have raised the new delays, rejections and inaccurate payment problems CDs and PCN lead practices have highlighted with the ICB.
NWL ICB Enhanced Services Single Offer
2024/25
Year-end Reconciliation process – we have reminded the ICB that it agreed to include the impacts of the NWL Pathology Lab errors on achievement as part of the year end reconciliation process. If this has impacted your practice or PCN performance this year you will need to follow the appeals process and provide evidence. The ICB has also said it can make corrections where there is evidence of errors in capturing performance. The final reconciliation has not yet been completed, but to date the budget is predicted to be slightly overspent, and the LMC and ICB congratulated PCNs on their efforts.
The LMC is aware that there are practices and PCNs impacted by demographic/deprivation issues and has raised the need to ensure that the current services do not unintentionally increase health inequalities, please see also below.
2025/26
The single offer services were launched at an ICB webinar on 30 April after consultation with the LMC. The access service has now been included in the single offer, with most LMC concerns taken on board. The ICB plans to hold regular webinars, with shared best practice and Q&A sessions.
The LMC continues to raise the following:
- Warfarin monitoring and funding – the ICB is reviewing the methodology and testing the costing assumptions.
- Diabetes – we will be meeting with the clinical lead to discuss patient safety, frailty and deprivation issues.
- The LMC continues to monitor the Respiratory Service and Medicines Optimisation Enhanced Service (MOES) on a quarterly basis following amendments made to this year’s specifications.
Borough level enhanced services
Although the single offer services were reviewed by the LMC before launch, some boroughs have launched services without prior consultation and the LMC will be raising issues for resolution through the year.
Practice level support programme
As outlined in its webinar on 22 May, the ICB has identified funding and will be working with the RCGP to support practices/PCNs, starting with those that withdrew or chose not to engage with Phase 2 of the access service in 2024/25.
ADHD services
Your LMCs are continuing its work in this area with meetings held with providers, raising feedback received from practices with further meetings scheduled. In addition, LMC Medical Directors will be meeting with the ICB lead. Please note: LMC guidance on Shared Care pathways can be found here .
Managing the Primary-Secondary Care Interface
The LMC is working with the ICB and Trusts to improve 4 priority areas:
- Onward referrals – guidance and a SOP have now been agreed.
- Complete care (fit notes and discharge letters) – Trusts are identifying priority areas for issuing fit notes; acute trusts are developing a template for discharge summaries.
- Call and recall- live across all acute trusts.
- Clear points of contact – the LMC has requested contact details to be included in headers of correspondence, starting with outpatient letters; following LMC and ICB challenge, Hillingdon Hospital has committed to provide an email contact for clinical and non-clinical queries within a month and a plan is being developed for the management of these queries.
Following LMC concern over individual Trust management of DNAs and private to NHS referrals, the ICB has shared the NWL ICS access policy. Please contact your Trust GP forum contact and LMC lead as detailed in our earlier newsletter if you are still seeing inappropriate discharges.
Londonwide LMCs new CEO
Dr Lisa Harrod-Rothwell officially became CEO of Londonwide LMCs on Tuesday 27 May, replacing Dr Michelle Drage who has retired after many decades representing London’s GP practices. Lisa is joined by Dr Elliott Singer who has stepped into the Deputy CEO role, which Lisa held for nearly 10 years.
Lisa’s message on taking up her new role can be read here, she is also on several social media platforms (X/Twitter , LinkedIn and BlueSky) and aiming to share updates on these more frequently.
LMC election nominations
Thank you to everyone who nominated themselves for their LMC and those who encouraged colleagues to do so. LMC election nominations closed at 5:00pm on Tuesday 3 June. The new committees will have their first meetings starting from October, following the completion of the full elections process across London. Until then your existing LMC representatives will continue to support you as usual.