GP practices reject ICB’s ‘clinically incoherent’ LES bundle
GP practices in an LMC area have rejected an ICB’s offer to take on a ‘clinically incoherent’ bundle of services.
Practices in the Gateshead and South Tyneside LMC area were among those offered an ADHD local enhanced service (LES), worth £117 per eligible patient per annum, but only if they accepted a large Medicines LES basket.
The Medicines basket, worth £2.87 per patient per annum, includes services like monitoring antipsychotics, shared care arrangements, and injectables services.
GP leaders had shared with Pulse their concerns about being asked to accept so many distinct services in one basket as a precondition for accessing the ADHD enhanced service.
Following a survey of its constituents, the LMC wrote to North East and North Cumbria (NENC) ICB last week stating the ‘overwhelming intention’ of GP practices to reject the offer.
In the letter, LMC chair Dr Paul Evans said: ‘We regret that the ICB has declined to take up the suggestions of multiple LMCs as to how services may be better-offered to the patient groups affected’.
Dr Evans said because the new Medicines LES offer would encompass some enhanced services already offered in GP practices, the rejection of the offer meant practices would need to hand back these services (including antipsychotics, lithium, DMARDs, amiodarone and ADHD medications).
According to Dr Evans’ letter, the ICB had previously claimed there would be an ‘array of alternative providers prepared and capable of taking on this work’ should GPs reject it, while assuring the LMC ‘no more resource would be offered to a foundation trust or private provider for the work involved’.
The LMC also reiterated its offer to explore alternatives with the ICB including:
- Giving practices the option to sign the ADHD LES without the Medicines LES;
- Rolling over, with inflationary uplift, existing LESs;
- Dividing the Medicines LES into ‘smaller, clinically-coherent LESs’.
Responding to the LMC letter, Dr Neil O’Brien, chief medical officer for NENC ICB, told Pulse: ‘We’re continuing to engage with LMCs and general practice colleagues across the region with regards to the Medicines LES and wider basket of services.
‘Our focus remains on developing consistent, equitable services for patients across the North East and North Cumbria, informed by ongoing feedback from practices.’
Pulse has reported extensively on how LES funding varies across England.
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