Welcome to the May edition of the NWL newsletter. WNL ICB formed on 1 April 2026; we will continue to communicate to practices in NWL and NCL separately on bespoke issues as needed. You will also receive WNL e-alerts and updates on shared issues as appropriate.
This month’s updates highlight the national and local issues that impact GP workload, safety, and patient care.
Your LMCs have been raising concerns with the ICB on a number of important areas, including advice and referral, community services, weight management pathways, recent hate crimes, radiology reporting delays and the recently published Single Offer Contract Variation for 2026/27 incorporating the new CRM Service and child health hubs. In each case, we have pressed for changes to be clinically safe, contractually sound, properly funded, and with no unfunded workload transfer to practices. Further detail is available below.
Following the recent ICB merger and the move to strategic commissioning, we are working to strengthen LMC representation in the new system governance, to ensure that general practice is involved in decisions that affect workload, patient safety and access.
Please keep sharing concerns and examples with us so we can represent practices effectively.
Dr Hannah Theodorou and Dr Asiya Yunus, Medical Directors for NWL, Londonwide LMCs
Jamie Wright, Director Primary Care, Londonwide LMCs
Surviving the 2026-27 GP contract – webinar recording
A recording of the first run of Londonwide LMCs’ webinar is now available on the 2026-27 GP contract guidance page for those people who were unable to attend either session.
You can find out about the effect on London of the contract changes, with our unique patient population and commissioning arrangements, based on the documentation available at the end of April.
Guidance and updates
GP contract 2026/27- Streamlining GP registration
NWL GP Shanker Vijayadeva has created advice to support GP practices with the GP registration component of the new contract. The recording is available on this link and the slides are attached here.
LMC support following recent hate crimes
Our thoughts are with everyone who has been affected by recent attacks and a series of reported arson and attempted arson incidents affecting venues and organisations linked to Jewish and Iranian communities in North West and North Central boroughs. We would like to remind you the Londonwide LMCs website includes The GP Survival Guide on Safety and guidance on Violent protests and disruption: GP surgery precautions and preparation.
Commissioning and enhanced services 2025/26
LMC and general practice ‘wins’
- 2025/26 SMS funding: following LMC representation, the ICB repurposed an underspend to support SMS costs which would have otherwise been covered by practices.
- Inflationary uplift: 2025/26 was the first year that the ICB uplifted the single offer twice in-year.
- Enhanced Services achievement: the ICB has sent a letter (PDF) recognising the outstanding achievements of PCNs across North West London.
- Following LMC review of achievement data and lobbying, the HbA1c threshold was adjusted in-year, with most PCNs then achieving 100% of the revised target.
- Non-diabetic hyperglycaemia 2025/26: while practice achievement was largely high for most PCNs, this was a particular challenge for Brent PCNs, who launched a successful appeal with LMC support.
Warfarin tariff: The LMC and PCN CDs jointly shared evidence of non-viability and a possible solution. The ICB acknowledged the issue but decided not to repurpose A&G DES underspend to support PCNs for 2025/26. However, for 2026/27 it has agreed to consider a small one-off retainer payment to PCNs if funding is available.
Commissioning and enhanced services 2026/27
2026/27 Single Offer Contract Variation
The contract variation has gone to borough teams to add local enhanced services, thereafter it should have been issued to contract holders for signature. We are gathering feedback from PCN CDs and reflecting it in our formal correspondence with the ICB regarding this process and outstanding concerns. The LMC letters relate to incorrect and/or inadequate tariffs, excessive workload and some areas of unintended clinical risk. The ICB has agreed quarterly reviews with the LMC to check whether targets are achievable, and recognised there may be in-year revision, notably for new services such as CRM.
Cardiovascular-Renal-Metabolic (CRM) Service:
The ICB has approved additional CRM funding for the next two years.
The LMC continues to raise:
- workforce and workload impacts of new ways of working including on other services being provided
- training requirements and practice readiness
- payment mechanisms
- template/IT issues
The ICB is running GP webinars and compiling FAQs to support implementation.
Child health hubs 2026/27
The LMC has presented evidence that the GP workload in the specification sent to practices has increased compared to the initial specification which we provided initial feedback on, while payment has halved compared with previous models. The ICB has stated that PCNs only have to demonstrate sessions have taken place, implying that this work does not need to be carried out by a GP. The LMC is monitoring this issue and welcomes feedback from CDs and practices.
Inflationary uplift 2026/27
The ICB has agreed an in-year inflationary uplift, subject to national confirmation of the amount.
Interface issues
Primary-community care interface
The LMC has commented on the draft community services that are being standardised across boroughs. The LMC aim is to Make Every Contact Count (MECC). We have requested a service gap analysis, any mitigations by borough and reassurance that this will not result in workload shift to General Practice. We have stressed the importance of communicating the new specifications to all stakeholders and setting up systems to receive and resolve issues.
The ICB has advised that this work is included in the Business Case for the ‘left shift’ 1% of funding being moved from the acutes into the community. The Business Case is going through governance and we will keep you updated.
Weight management pathways and QOF indicators
National and local discussions are ongoing. In the meantime, the LMC has raised concerns about lack of local pathways, weak or no wraparound support, and inappropriate expectations of general practice. The ICB-commissioned provider, Oviva, has prescribed only Wegovy, rejected some referrals, and asked GPs to prescribe Mounjaro/Tirzepatide inappropriately. This has been flagged directly to the ICB.
The QOF indicator requires shared decision-making about weight-loss medicines, not routine GP prescribing. This can be met through GP case-finding followed by a shared decision-making discussion about the weight management service.
The LMC has asked for clear educational resources for patients, providers, and practices as well as appropriately commissioned wrap-around care. The ICB has agreed to update its web pages and provide guidance through a GP webinar and primary care bulletin.
Primary-secondary care interface
Advice and referral
The LMC has written to Professor Tim Orchard, CEO of the NWL Acute Provider Collaborative, about the rollout of elective Single Point of Access pathways in North West London and their impact on practices and patients.
Guidance is clear that these pathways should be co-designed with local GP leadership, including LMCs, which has not been the case in NWL.
The LMCs have shared BMA GPCE guidance on the GP role and asked for an urgent pause so implementation can be redesigned jointly.
Radiology reporting delays
These are being taken up at the LMC-provider interface meetings.
Soft tissue sarcoma pathway
The ICB has agreed to investigate current arrangements and provide a clear update to practices on the correct referral process and available services.
Tell us about your practice’s purchasing needs and win a £20 gift voucher
Our new survey on what you buy, and why you buy it, will help us improve our offer of goods, services and training. Five respondents will also win a £20 gift voucher. The survey covers several areas, you only need to fill out the ones relevant to you – we know how busy everyone working in general practice is!
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