Dear colleague,
Chair’s introduction
There are significant threats to Tower Hamlets General Practice as we know it. Thank you all for continuing to support your LMC. We are here to represent you, but we only have influence if you support us. Whilst network funding is under significant scrutiny it is a time for all of us to pull together to demonstrate the value of Tower Hamlets General Practice.
We need to show how well we work together for the benefit of our patients and we need to show how we will be able to deliver in the future if commissioners choose to invest in us.
Best wishes,
Dr Emma Radcliffe
Chair
Tower Hamlets LMC
Tower Hamlets LMC contact details
What has Tower Hamlets LMC been working on recently?
Enhanced services review
You will be aware that the ICB has served notice on several key Tower Hamlets enhanced services while they undertake a review of these schemes. We are working very closely with colleagues within the PCNs and the care group to ensure the ICB understands what will be lost if they defund our Networks and services. Following LMC input, the ICB have said they are committed to the principle or retaining funding within the borough. However, we anticipate signficant further discussions over the coming months. There are a lot of key Tower Hamlets services to defend.
GP Forum
Thanks to all those who attended this event. We showcased the LMC interface document which we would encourage you all to read and start using. It is based on national guidance about how we should interact with our secondary care colleagues and vice versa. There were lively discussions about shared care and prescribing. The LMC has produced guidance and position statements on DOAC prescribing, obesity (including GLP-1 prescribing) the ADHD LIS and Shared Care. Please contact ian.williamson@lmc.org.uk.
Tower Hamlets GP Care Group jointly hosted the event. There were lots of ideas forthcoming about neighbourhood working and the use of data to shape this.
PCIT transition
The transition from CEG to Primary Care IT remains a significant operational issue for practices across NEL. PCIT went live from 1 August, but practices continue to report usability problems, including searches, referral trees, coding and uncertainty that clinical activity is being correctly captured. Concerns have been raised that missed or misrecorded activity could affect clinical care, safeguarding and future scheme reporting. The LMC is concerned that there has been no significant training programme put in place, but the training hub have kindly facilitated two PLTs now at our request.
The ICB has advised that the NEL CCIO is supporting a stocktake and structured quality-assurance review. PCIT developers and users are working to prioritise fixes and more substantial changes, with borough engagement sessions, coding support and online guidance being developed.
The LMC position remains that practices should not be financially penalised for system delays, data issues or technical gaps outside their control. We continue to press for clear timelines, training, assurance and income protection. Please continue to report missing codes, technical problems and other transition concerns through established local channels so that issues can be consolidated.
Barts clinic letters
Tower Hamlets GPs continue to report problems with clinic correspondence from secondary care. The LMC has met with the clinical lead and Deputy Chief Medical Officer of Barts. Further work is underway to improve communication quality. We have asked for communications to be sent to practices acknowledge concerns and outline remedial action.
Practices are recommended to continue raising Quality Alerts where patient safety issues arise, record examples of problematic letters, and notify the LMC if trends emerge.
DOACs prescribing and monitoring
The previous Tower Hamlets contractual arrangement for DOAC monitoring has been withdrawn, but the LMC position remains that DOAC monitoring is not core contractual general practice work and should not be expected without appropriate commissioning and funding.
Londonwide LMCs has raised this with the ICB and through wider London discussions, as the issue has implications beyond Tower Hamlets and links directly to shared care, high-risk prescribing and unfunded workload transfer. Commissioners have indicated a view that ongoing monitoring may sit within core general practice, but NEL LMCs have challenged this and have asked for the contractual basis to be clearly set out.
Until this is resolved, we recommend that, for patient safety, practices continue prescribing for now, but under protest, making clear that this does not constitute acceptance that the work is core. Practices should review the financial implications and retain evidence of referrals rejected by relevant clinics, as this may help demonstrate that no commissioned alternative service exists.
NHS England list cleansing (FP69)
Londonwide LMCs are challenging the NHS list-cleansing process because of its potential impact on people without a fixed address, those missing from ONS data, students and other vulnerable groups. Local practices have reported substantial patient losses – we heard that one student-focused practice has reported losing more than 3,000 patients, with further losses of around 700–800 every three to four months and significant administrative and financial pressure.
We recommend that practices check the FP69 notifications you receive, and seek to contact patients before removal. You could consider patient communications to reassure that list-cleansing letters are genuine and encourage prompt response. Record “no fixed address” where appropriate using the NHS England option, which should help protect affected patients from inappropriate removal. Practices are also encouraged to share anonymised examples and impact data on wrongly removed or vulnerable patients with Londonwide LMC. (You can contact ian.williamson@lmc.org.uk). Tower Hamlets LMC has written to all three MPs who have constituencies in the borough to explain how practices are being destabilised by this process. Londonwide LMCs guidance is available here.
NEL interface consensus and Barts engagement
NEL LMCs continue to progress the Londonwide interface consensus document as a framework to support practices in challenging inappropriate workload transfer between primary, community, mental health and secondary care services.
A positive development has been the recent Barts interface workshop, where Dr Emma Radcliffe, Tower Hamlets LMC Chair, presented the Londonwide interface document on behalf of NEL LMCs. This secured constructive engagement from senior Barts colleagues and agreement to develop a Barts-wide interface document by December 2026, with socialisation and implementation between then and March 2027. Local LMCs are expected to be involved in co-production.
Barts also committed to progress electronic consultant-to-consultant referrals, including two-week-wait referrals, by March 2027, and to explore further priorities including a directory of services, a “You said, we did” newsletter for GPs, greater GP involvement in education and research, and the potential role of a GP liaison officer.
The LMC view remains that a NEL-wide interface solution is needed, but securing Barts engagement is an important step forward and a potential model for wider system adoption.
Adult ADHD LES
Practices were asked to sign up to the LES by 9 October 2026. NEL LMCs’ position on this specification remains largely unchanged from previous communications – the final version of the specification has not addressed all of LMCs’ serious concerns raised. These included that the pathway does not appear to be NICE compliant, care is transferred not shared, the tariff is far below comparable schemes elsewhere and NHS national payment guidance, and there is still no formal NEL accreditation for Right to Choose providers. Therefore Londonwide LMCs is not able to endorse this specification. There is a fuller statement in the NE London sector newsletter.
During discussion, Londonwide LMCs secured an improvement in the form of a clarification that patients should only transfer to general practice once medication has been initiated, titrated and stabilised, with ELFT/NELFT providing specialist advice and re-titration support. However, this support is not yet live and LMCs remain unconvinced that the providers will be able to meet the stated 24-hour urgent and 72-hour routine response times.
The LMC view is that practices should think very carefully before accepting any scheme that transfers specialist prescribing and monitoring responsibilities without adequate funding, safeguards and continuing specialist support. Practices should consider these risks carefully before making any decision to sign up.
North East London sector issues
Many issues affecting Tower Hamlets also affect other boroughs in NEL and we work closely with our counterparts to address and resolve them at sector level. We produce a NEL newsletter for the sector work.
The latest issue of the sector newsletter contains a spotlight on guidance on the GP Reimbursement scheme, commissioning updates on LES reviews, Same-Day-Access and others, and other sector news including ICB Clinical Director roles, and our proposed secondary care interface principles. You can read it here NEL Newsletters.
Get new deals with the Londonwide LMCs Buying Group
Our Buying Group suppliers not only offer great deals to practices looking to switch, they also aim to offer the best value to existing customers in the Londonwide LMCs area, including explaining new products and features as they get rolled out.
- X-on Health – Brings together cloud telephony, AI-powered care navigation, voice agents, ambient voice technology, and data to improve access and reduce practice pressure.
- Practice Index – Pick and choose what you need out of their learning platform, or software to manage HR, finance, compliance and rotas.
- Hippo Labs – Have your call-and-recall work smarter, reach more patients and improve QOF attainment. Now with a new pay per appointment booked, subscription-free option.
- Equity Energies – Reduce energy costs, save time, become greener and remove the administrative burden of managing utilities by having experts do it all for you.
- MIAB – You existing policies may have more gaps than you think, particularly in developing areas like cyber and ARRS employment. Rely on MIAB’s specialist expertise to ensure you are fully covered.
- Restore Information Management – Whether you need a room full of records doing or a steady flow of new registrations, Restore take the hassle out of digitising patient records.
- Tickets for Good – Reward yourself and your colleagues with free and discounted tickets to concerts, theatre shows, sports and more!
- Hillcroft Surgery Supplies – Get next day delivery and industry leading stock availability, thanks to their investment in substantial warehouse facilities.
Engaging with Tower Hamlets LMC
We are keen to listen to practices, to understand the issues they are worried about and the challenges they are currently facing – let us know if you would like a call or for an LMC member to visit your practice for a conversation. Please email ian.williamson@lmc.org.uk.
Please also visit the Londonwide LMC website for a one-stop shop on our support for practices—details of our services, practical resources (including template letters and guidance), and details of your Newham LMC committee, including meeting dates and previous local and NEL newsletters.