ICB agrees to fund new locally-commissioned services following GP collective action

GP collective action in Kent has led to an agreement from the ICB to fund new locally-commissioned services, including for CVD and ADHD.

Kent and Medway ICB agreed to work with the LMC to develop the services after GP practices served notice on unfunded work as part of collective action.

Practices were encouraged by Kent LMC to serve notice on any voluntary services undertaken to plug local commissioning gaps, including ADHD and inclisiran prescribing, specialist drug monitoring, gender dysphoria services and more (see box).

To address the areas practices have served notice on, the following will be implemented by the ICB in Kent:

• access to shared care medication through one Shared Care Locally Commissioned Service (LCS) – the ICB is expecting this to be in place in quarter one of 2025/26

• a direct oral anticoagulant (DOAC) monitoring service which the ICB and LMC are currently discussing, also to be in place in quarter one of 2025/26

• the pathway for prostate-specific antigen (PSA) monitoring if requested by secondary care for non-cancer patients is being reviewed

• a proposal on administration of inclisiran is being developed for discussion with the LMC.

While the areas above are worked through, the ICB has agreed to provide 20p per weighted patient in lieu of the shared care LCS and DOAC-monitoring service.

This will be put in place in the first few months of 2025/26 and payment is planned for the April pay run, the ICB added.

In an update to Kent practices, the ICB said: ‘We would like to thank colleagues in general practice for your understanding while we worked through these arrangements and for making sure patients continue to be supported.’

It follows six months of GP collective action during which practices have been able to choose from a list of nine options recommended by the BMA.

Following the 2025/26 GP contract deal, collective action is still in place but aimed at ICBs rather than the Government, according to the latest update. However, LMCs are meeting for a special conference tomorrow during which they will decide on future collective or industrial action.

Pulse has previously reported on GPs in several areas coming together to serve notice to their ICBs on unfunded work as part of collective action, including various services and shared care arrangements, such as PSA monitoring, phlebotomy, ring pessaries and ECGs.

Kent LMC said: ‘We continue to work with the ICB to deliver the actions outlined and will update practice as negotiations progress.

‘Adhering to or implementing the BMA safe working standards does not stop. Please continue to work safely and look after yourselves, your patients and the whole practice team.’

According to data recently gathered by Pulse, GP collective action has been estimated to cost on average £2m to each ICB.

Practices have taken action serving notice on any underfunded services, which has produced a financial impact in some areas, including Humber and Yorkshire, where both local ICBs said they had to provide an extra £1.6m to mitigate against practices servicing notice on locally-commissioned services.