GPs in one ICB area will see a £14m boost to local enhanced services (LES) funding, celebrated by their LMCs as a ‘huge’ achievement.
Lancashire and South Cumbria ICB last week agreed to fund a new expanded medicines optimisation LES and a long-term conditions LES, which represent a ‘significant investment in general practice’.
The changes to LES funding in 2025/26 also address ‘historical variation’ across the area – resulting from previous CCG footprints – and mean that the ICB is now ‘consistently commissioning’ all routine local enhanced services.
This large boost to discretionary local funding means that if GP practices deliver all LESs available, they will have access to £26.46 per patient.
In a message to practices on Thursday, Lancashire and Cumbria LMCs celebrated their success in ‘galvanising the profession’ to stand up to unfunded work, suggesting that the ICB’s decision ‘would not have been possible’ without ‘collective effort’ from GPs.
Dr Adam Janjua, CEO of the LMCs, told Pulse that practices have been pushing for fairer LES funding for the last 20 months, and that BMA-led collective action helped as it ‘brought the spotlight on to the free work that GPs were doing’.
In March, the LMCs raised serious concerns about delays to the ICB’s decision on 2025/26 funding, which they called ‘unacceptable and entirely avoidable’.
‘As the representative bodies for general practice, the four LMCs find it incredibly disrespectful to the 196 GP practices across Lancashire and South Cumbria that remain in limbo regarding their financial futures and future commissioning arrangements, having been left waiting for much needed clarity,’ Dr Janjua wrote to the ICB’s senior leadership on 25 March.
The LMCs also accused the ICB of ‘repeated backtracking on its financial commitments’ by proposing funding below its previous promises.
But Dr Janjua told Pulse that the final decision, made by the board on Thursday, represents a ‘good achievement’ from the ICB ‘for recognising the fact that general practices needed more funding’.
He said local commissioners faced issues with commissioning local enhanced services equitably as a result of merging five CCG areas into one ICB area in 2022.
‘Obviously the ICB then had a problem of, how do they bring it all up to the highest level, rather than cutting from the top people and then putting it into the pockets of, say, the GPs that were earning five times less.’
Dr Janjua said it has taken almost two years to ‘equalise the earnings across Lancashire and South Cumbria’, so the recent announcement is a ‘big, big achievement’.
It followed an ICB-wide review of local enhanced services, with the LMC drawing up a list of activities that were previously ‘unpaid’, such as phlebotomy, ECGs and spirometry.
But the LMCs CEO said their tactic was to continue providing those services – rather than stopping them altogether – with the ‘promise of getting the funding for it in the next financial year’.
Now that the LMCs have secured this funding, Dr Janjua said: ‘For the first time ever, we’re being paid for stuff that we were doing for free, which we shouldn’t have for decades. So it’s a huge event.’
His update to practices on Thursday said: ‘We welcome the ICB’s recent update outlining the Board’s decision and are pleased to see that our work in galvanising the profession across the system to stand together has had an impact on decision making at Board level.
‘We look forward to further clarification on the specifics of this funding, which represents a commitment to investing in excess of £14m extra funding (compared to last year) into general practice as part of a major shift of resource, in due course.
‘We understand that all practices, if delivering all LESs, should have the ability to access the £26.46 pwh previously offered.’
Lancashire and South Cumbria ICB confirmed these figures, and said it was working closely with the LMCs to ‘now progress the delivery of the new LES’.
Medical director Professor Andy Knox said: ‘We are pleased to confirm that the ICB board has agreed to fund the new expanded medicines optimisation LES and the long-term conditions LES.
‘This means that going forwards the ICB is consistently commissioning all the routine LES and long-term conditions LES we’ve discussed.
‘This consistent commissioning represents a significant investment in general practice and addresses historical variation across Lancashire and South Cumbria.
‘It forms part of the national and local strategic move towards community-based care and our commitment to a robust, resilient and thriving general practice.’
Professor Knox also said the ICB is operating in a ‘financially challenged system’ and recognised that this has ‘resulted in delays’, for which he apologised.
Pulse recently reported on Somerset GPs reaching an agreement with their ICB for an extra £2m investment to cover services such as ADHD, minor surgery and bariatric surgery monitoring.
The LMC said this extra money will ‘address gaps in service’ that have been ‘highlighted through collective action’.
As part of collective action last year, GPs in several areas came together to serve notice to their ICBs on unfunded work including various services and shared care arrangements.
