Welcome to the latest updates and advice from your LMC representatives.
Advice and guidance
Delays in Advice and Guidance (A&G) responses continue to cause significant problems, particularly in gastroenterology where urgent cases are waiting prolonged periods for advice. Practices need access to expected A&G response times and outpatient waiting times so patients can be advised appropriately. The LMC is seeking greater transparency on waiting times and clearer escalation routes where responses are delayed.
A new process is needed to ensure ownership of A&G queries and timely escalation when patient care is affected. In the meantime, delays in response times should be flagged to the ICB via the NEL Quality Alert system.
Secondary care interface
Regular secondary care interface meetings need to resume to address ongoing referral, shared care and interface issues. There is increasing concern that many hospital services remain unaware of the impact that inappropriate workload transfer has on general practice.
Work is continuing across North East London to strengthen arrangements for returning unresourced work to secondary care. Other London systems have introduced standardised templates that allow practices to challenge requests that fall outside the GP contract, and similar approaches are being explored locally.
The LMCs in NEL are pressing the ICB to take a strategic view on the interface work in NEL and develop NEL Consensus Principles on Interface working, as other ICBs in London have already done.
Audiology referrals
Practices continue to receive requests from community audiology providers to make referrals for NHS hearing aids after the provider has already completed the hearing assessment and determined that hearing aids are required.
This creates unnecessary administrative work and duplicates clinical processes. Providers should be able to refer directly for hearing aid services, whether within their own organisation or to hospital audiology, without requiring a further GP referral.
The LMC is raising this issue with commissioners and providers. Practices should use the NEL Quality alert system to flag this issue to the ICB.
Maternity prescribing
There has been a welcome reduction in requests from community midwives for GPs to prescribe antibiotics following routine urine samples, as midwives are no longer undertaking routine mid-stream urine tests.
Practices are reminded that agreed maternity prescribing protocols already exist. Midwives working within those protocols should arrange appropriate prescribing through maternity services rather than routinely asking GPs to prescribe. Where requests continue to be made outside the agreed pathway, practices should refer to the existing protocol and raise a NEL Quality alert.
GP engagement event
Feedback from the recent GP engagement event was overwhelmingly positive. Attendees valued the practical focus on topics such as ADHD, long-term conditions and shared care, with clear, step-by-step guidance proving particularly helpful.
There was strong support for holding similar face-to-face events during Protected Learning Time, alongside practice- and PCN-based learning. Future sessions are expected to focus on contractual changes, shared care, interface issues and practical support for general practice. The LMC is working with the NEL training hub, FedNet and local clinical leads to ensure sessions are aligned and useful to GPs in Waltham Forest.
ICB and neighbourhood developments
The new ICB Chief Executive has met with Waltham Forest clinical leaders to hear directly about local challenges. Key issues raised included digital infrastructure, GP Connect, estates, education and training, shared care, neighbourhood development and inequity across North East London.
The ICB continues to recruit clinical leadership posts, including several borough-level roles covering areas such as frailty, women’s health, young people and neighbourhood working.
Practices have also highlighted uncertainty about ICB leadership structures following the recent organisational changes. As appointments are confirmed, clearer information on roles and responsibilities is expected to improve communication between practices and the ICB.
Neighbourhood development funding has been confirmed for the next three years, although there is concern that available resources will be insufficient to deliver the scale of transformation expected without additional workforce, estates and digital investment.
Primary Care IT
Primary Care IT (PCIT) has been appointed to replace CEG at the end of their contract and will begin supporting practices from 1 August 2026.
Work is underway to deliver clinical searches, templates and recall functionality, although implementation depends on completion of information governance and data-sharing agreements. Practices should be aware that new templates cannot be released before the new contract formally begins.
There is concern that delays could affect QOF support early in the year. Practices should continue to use existing resources where available while updated templates are prepared. PCIT sends regular newsletters and updates directly to practices. We encourage practices to read this information.
Londonwide LMCs are also actively engaging in discussions and provide regular updates in the NEL newsletter.
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 and other LMCs produce a pan-NEL newsletter for the sector work. The most recent issue covered FP69 deductions, PCIT, the LTC Proactive Care QOF, Same-Day Access and other topics.
Well done to the prize draw winners from our Buying Group survey!
Thank you to everyone that took part in our Buying Group survey, we plan to run another one in the autumn. The randomly selected winners of the gift vouchers were:
- Trudy Do, Havergal Surgery
- Karen Tobin, The Bromley Common Practice
- Anca Radulescu, St. Margarets Medical Practice
- Marian Negoita, Amersham Vale Practice
- Aparna Pal, Jubilee Garden Medical Centre
Our Buying Group suppliers are:
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- Practice Index – Pick and choose what you need out of their learning platform, or software to manage HR, finance, compliance and rotas.
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- 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.
- Surgery Connect – Automates more tasks within your phone system, integrates with clinical records and seamlessly bridges in and out-of-hours.
- 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 it 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!
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.
Best wishes
Dr Asad Ashraf
Chair
Waltham Forest LMC