Chasing payments, challenging unfunded workload and raising patient-safety concerns are at the heart of the LMC’s work this autumn. Here’s what the LMC has done on your behalf, we’ve highlighted where discussions are continuing and what your team can do next.
1. Chasing delayed payments and pressing for winter funding
LMC action: Raised rejected claims and late or missing payments directly with the ICB’s finance and primary care contracts teams, using examples of the impact on practices.
Progress: The ICB is bringing in additional resources to clear the backlog. Payments are expected to start from November 2026, with further Q&A webinars, FAQs and a manual planned.
For your team: Check claim status by logging into CQRS Local, attend the primary care webinars and share examples of unresolved payment problems with the LMC.
- Not there: claim not submitted correctly
- Awaiting tier 1 approval: submitted but not yet assessed
- Awaiting tier 2 approval: assessed as OK and awaiting approval for payment, should appear in next available pay run.
Winter pressures
LMC action: Wrote to the ICB challenging the lack of engagement with, and support for, general practice in its winter plans.
Progress: Following these representations, the ICB identified £4 million for general practice across West and North London. The LMC continues to raise concerns about funding milestones and flexibility.
2. Raising messaging safety concerns and protecting practice lists
AccuRx
LMC action: Met the AccuRx lead to raise concerns about messages reaching unmonitored practice inboxes without sufficient unread-message safeguards.
Progress: AccuRx provided guidance on recent changes (‘at a glance’ guide to recent changes) and confirmed that practices can request that Accumail be switched off without affecting patient email or SMS functions. The LMC continues to raise the outstanding concerns.
FP69 list cleansing
LMC action: Londonwide LMCs is pressing for mitigation, financial protection and reinvestment of released funding, highlighting the impact on small practices and those serving homeless and university populations. We have provided important case studies from the North West highlighting these problems. Concerns continue to be raised with NHS England.
Progress: PCSE has added Scenario 5 to its guidance. A pilot of a new patient SMS-response option is forthcoming. Further concerns and supporting data are due to be raised by the LMC at the London regional Neighbourhood Health Board.
For your team: Keep checking the updated list-validation guidance at Londonwide LMCs.
3. Challenging referral problems and improving joint working
SPOA/advice and referral pathways
LMC action: Sent a joint letter with Surrey & Sussex LMCs challenging the pathways and their impact on practices and patients.
Progress: Trusts agreed to a pause and rapid review. A working group met in August, and an action plan was drawn up. Joint practice visits are planned, with two LMC chairs’ practices volunteering as the first “test and learn” sites.
Hospital and community services
LMC action: LMC leads are raising the lack of a clear forum for discussing strategic concerns with senior hospital and commissioning leaders.
Next steps: LMC leads are scoping out examples with Trust leads and how best to engage.
Cora Health
LMC action: A meeting with Cora Health is planned to address musculoskeletal service problems reported by practices. The LMC will share updates as these discussions progress.
4. Escalating IT disruption and challenging hardware costs
CIS2 rollout
LMC action: Asked the ICB to register the disruption as a serious untoward incident, provide additional helpdesk support and improve communications to practices and patients to reduce pressure on practice staff.
Progress: The ICB deployed available staff, reverted to the previous version, restarted the update and informed practices. It has agreed that future updates will be automatic and that the incident will be registered and investigated.
Laptops
LMC action: Following reports of reduced support for new and replacement laptops and a proposed £1,500 charge for an ICB-controlled device, LMC leads are raising this with ICB IT leads to discuss possible mitigation or use of available budgets and will keep you informed.
MESH
LMC action: Raised operational problems affecting EMIS, EMIS Docman and S1 practices with ICB and NHS England regional IT leads. Regular discussions are continuing to review progress and mitigation.
For your team: Log MESH problems with:
- nhsnwl.servicedesk@nhs.net.
- thh.gpliaison@nhs.net for Hillingdon Hospital-related issues.
Copy in the LMC if your issue needs escalation.
5. Making enhanced services safer and more workable
LMC action and next steps:
- CRM and MOES 2026/27: Meeting with the ICB about possible in-year changes to improve patient safety and practice viability.
- Access Service: Raised PCN and practice concerns about 2025/26 and 2026/27 data and payments. The ICB will issue clarification.
- S1/NHS App functionality: Repeated practices’ concerns; the ICB IT team will raise these again with TPP.
- ADHD services 2027/28: Taking part in a task and finish group and proposing a funded hub model led by GPs with specialist expertise, rather than delivery by individual practices. This is the LMC’s preferred approach, not an agreed service model.
- Enhanced services from 2027: Requested discussions about aligning NCL and NWL services without disrupting patient care or destabilising practices.
6. Making sure general practice has a voice in future plans
LMC action: Challenged assumptions in the WNL Ten Year Plan that general practice can fill service gaps without additional funding. LMC representatives met the ICB’s Chief Strategy Officer, called for earlier involvement in planning and followed up in writing. A response is awaited.
Londonwide LMCs has also responded to the national neighbourhood contracts consultation, emphasising the importance of LMC involvement in negotiating new contracts.
Progress and next steps:
- The ICB has established neighbourhood-working workshops involving the LMC.
- The LMC has been invited to represent general practice on two new ICB committees.
- Meetings with the Primary Care Provider Collaborative’s new chair and invitations to its board directors are planned to strengthen local relationships.
The central message: General practice needs the funding, workforce and premises to deliver services safely—not additional responsibilities without the resources to support them.
Keep sharing your practice’s experience
Your examples help turn individual problems into a stronger case for change. Please continue sending concerns and practical examples to lesley.williams@lmc.org.uk so the LMC can identify shared issues, escalate risks and represent your team.
Get new deals with the Londonwide LMCs Buying Group
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