GPs in one area are still waiting on payment for an ICB-commissioned advice and guidance (A&G) scheme which began in 2022.
Following lobbying from the LMC in 2022, North East London (NEL) CCG agreed to pay roughly £19 per A&G request in order to cover the extra work that comes back to GPs as a result of actioning specialist advice.
This funding was carried over for Tower Hamlets, Newham and Waltham Forest when the ICB was established later in the year, and the project developed into ‘advice and refer’ whereby all referrals went through a ‘single point of access’.
Pulse reported in July last year that the ICB had cut funding for the scheme as GPs had fallen short of the ‘required targets’.
At the time, GPs also raised concerns about the ICB’s failure to make payments under the scheme, and said they had been promised progress ‘very soon’.
But eight months later, local GP leaders have told Pulse that practices have still not received any payment for the two years the scheme was running.
NEL ICB said it has commissioned an independent organisation to ‘review the scheme’ as well as ‘monies owed to practices’.
It confirmed that once the review has been completed this month, the ICB will be able to ‘make any payments due to practices’.
Tower Hamlets LMC member Dr Selvaseelan Selvarajah told Pulse he is ‘not aware of any practice that has been paid’, and that local GPs ‘haven’t had any update from the ICB either’.
He said the ICB’s rationale for not paying practices was that they ‘didn’t hit the target’, since there was a ‘minimum number’ of A&G requests they had to do.
‘But the issue was that it wasn’t agreed – there was no target that was agreed, the agreement was that we’d be paid per advice and guidance done,’ Dr Selvarajah added.
East London GP practices ‘have always had a tradition’ of ‘trialling new innovations’, but the ICB’s failure to provide agreed funding for A&G may negatively impact this, according to Dr Selvarajah.
He said: ‘When an agreement like this isn’t taken forward and we’re not paid, it will make the GPs very hesitant to go forward with anything new that comes from the ICB.
‘So I think it’s important, once you agree something, you get paid for the work, so we can all move forward.’
A spokesperson for North East London ICB said: ‘After agreeing a specification with Londonwide LMCs, we commissioned an independent organisation to review the scheme, its specification, effectiveness and monies owed to practices across north east London.
‘The review completes this month and we will then be in a position to make any payments due to practices.’
The BMA has officially accepted the 2025/26 national GP contract which includes a new enhanced service for A&G.
From April, practices will be able to access a £20 Item of Service (IoS) fee for ‘pre-referral requests’, from a total funding pot of £80m.
NHS England later clarified that £80m is the national limit, but it will be up to ICBs ‘how they apply that’.
