Dear colleague,
Chair’s introduction
As we move through another busy and challenging period for general practice, I want to take this opportunity to thank all colleagues across Waltham Forest for the commitment, resilience and care you continue to show every day. We know practices are working under sustained pressure, while also having to respond to a wide range of system changes and service issues.
In this newsletter, we share updates on some of the key matters we have been working on locally and across North East London, including interface issues with hospitals, prescribing concerns, discussions with mental health services, public health priorities and the ongoing enhanced services review.
Your LMC remains committed to representing your views, raising concerns where needed, and working to ensure that the voice of general practice is heard clearly. We are always keen to hear from you, so please do get in touch if there are issues affecting your practice that you would like us to take forward.
Best wishes
Dr Asad Ashraf
Chair
Local engagement
Secondary care interface update
LMC member Dr Mike Grenville has raised GP issues at the secondary interface meetings. Whipps Cross now provides all wards and clinics with fit notes, though they are not yet able to put them online. They have agreed that notes should be issued for the time that patients are expected to need off work, rather than leaving a predictable need to go to the GP for an extension. There has been extensive discussion of Advice & Guidance response times: some issues within the hospital have been resolved which should improve matters, and Whipps have said they will produce a guide to expected response times by department. E-prescribing is moving ahead and they are beginning to issue electronic FP10s, though hospital prescriptions can only be dispensed in the hospital.
North Middlesex referrals rejections
We have become aware that some GPs in Waltham Forest have had referrals to North Middlesex hospital (now part of The Royal Free) rejected based on patients being out of area. GPs who are experiencing this, are advised to raise Quality Alerts to NEL ICB as per normal process.
We are also discussing this issue with counterpart in North Central London (where North Middlesex is commissioned) to take it to their interface meeting for discussion.
Prescribing for maternity services at the Homerton
Waltham Forest LMC is aware of concerns regarding Homerton maternity services asking GPs to prescribe antibiotics. The local LMC has been working extensively with Homerton to resolve this and progress is now being made, with the service moving towards electronic prescribing so prescriptions can be sent directly to patients’ community pharmacies. In the interim, for patients outside City & Hackney, Homerton should provide prescriptions directly for collection from the hospital. So if you are still receiving prescription requests from the Homerton’s Maternity service, please raise a Quality Alert.
We are also approaching Whipps Cross to ensure a similar solution is adopted by the local maternity service.
Discussions with NELFT
- At our March LMC meeting, NELFT told us they are working to manage mental health in the community and integrate working with GPs in neighbourhoods. There is an Integrated Care Assessment Hub as an alternative pathway to the emergency department. The ICAH is currently in Goodmayes and they are aware that patients prefer sites that are more local, so they are looking to open another in Waltham Forest.
- NELFT are in the process of shifting to electronic referral via Elemental, which sits in EMIS and will get more services added to it. GPs fill in the usual form, attach it within EMIS within their workflow and are notified of outcomes the same way.
- We discussed ADHD services; both LMCs and NELFT see this as a commissioning gap – discussions with the ICB on a funded GP service are ongoing. We also requested a directory of services and referral criteria, including those that patients can self-refer to.
- Finally, the LMC Chair and the MD for Fednet, discussed more recently with NELFT the model for domiciliary phlebotomy in Waltham Forest, now that the ICB has removed the domiciliary phlebotomy tariff from the GP Phlebotomy LES. This may result in increased pressure on the community phlebotomy service. There is appetite to look at different models for domiciliary phlebotomy and potentially subcontract practices/PCNs to deliver it. We will update practices as further discussions take place.
Public Health update
Waltham Forest public health is keen to work with GPs who have capacity for call/recall about vaccinations such as MMR, in the context of the measles outbreak in nearby boroughs such as Enfield and Haringey – there have been a few isolated cases in Waltham Forest too.
We confirmed with them that existing commissioned services such as sexual health, emergency contraception and smoking cessation are continuing, and that GPs should continue to use existing channels. For gym referrals, GPs are asked to use Breeze Waltham Forest.
Changes to the Integrated Care Board
NE London ICB’s new, much smaller, structure has been announced. Staff taking voluntary redundancy are leaving this month and recruitment to posts in the new structure has begun and will continue for several weeks. The ICB’s capacity will clearly be reduced, and familiar contacts will be changing.
GPs and practices are advised to use, or at least copy in, the ICB general contact address nelondonicb.nel-primarycare@nhs.net as individuals may have left. Enquiries will be routed from the general address to current responsible staff.
Enhanced services review
We have received confirmation from the ICB that a number of local schemes will be rolled over to 2026/27 pending a full review. These are: the 48-hour asthma review (children), the Vulnerable children service, NELFT’s mental health and the Homeless pilot.
All other schemes will either be superseded and incorporated in the new NEL LTC Quality Outcome Framework; some will be redesigned and reinvested, such as the QI scheme and Childhood imms.
In terms of the new NEL LTC Quality Outcome Framework. The LMC has joined the Waltham Forest Local Implementation Group (LIG) which met in March to start the process of engaging local stakeholders in the implementation of the scheme. We will keep practices informed of progress and developments.
OMNES Quality alerts
We are aware of continuing issues with OMNES and the quality of their diagnostic reports. Using the NEL Quality Alert system is still the best way to raise concerns about their service. Please follow the process in this site Quality Alerts – North East London and email the Quality alerts team at nelondonicb.qualityalert@nhs.net
If you are also encountering issues on the ground we would like to hear about it. You can contact ian.williamson@lmc.org.uk (no confidential patient information please).
North East London sector issues
Many issues affecting Waltham Forest 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 most recent issue covered the NEL enhanced services review, the new NEL community anticoagulation service, NEL Quality Alerts, Blue Badge requests and other topics. You can read it here NEL Newsletters.
Exclusive deals for practices
Our substantially updated Buying Group offer provides a range of opportunities to save money and improve the quality of products and services you use.
- Hillcroft Surgery Supplies – Get excellent prices and next day delivery on consumables, with a supplier who can respond quickly to your practice needs.
- Practice Index – Access a comprehensive online learning platform, plus packages to manage HR, finance, compliance and rotas.
- 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 – Let a specialist GP insurer make sure you have the right cover, with knowledge on developing areas like cyber security, AI scribes and contract holding at PCN level.
- Restore Information Management – Our records digitisation partners can help free up premises space and recent changes with the National Document Repository have improved practices’ options.
- Hippo Labs – Intelligent, end-to-end call-and-recall automation does more than simply send reminders, it tailors messages and helps to improve QOF.
- Surgery Connect – The latest in cloud telephony integrates with clinical systems, provides stats on patient contacts and automates many tasks.
- Tickets for Good – Reward yourself and your colleagues with free and discounted tickets to concerts, theatre shows, sports and more!
Engaging with Waltham Forest 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 Waltham Forest LMC committee, including meeting dates and previous local and NEL newsletters.