ICB imposes GP call response targets as part of £6.6m access funding

New ICB plans to improve primary care access in London will require GP practices to respond to calls within 10 minutes and online consultations within one day.

North West London ICB has set out the 2025/26 specification for its access enhanced service, worth £6.6m, after it was forced to scrap a controversial proposal for same-day hubs last year. 

The funding this year is part of the ICB’s ‘single offer’ for its bundle of enhanced services, which means PCNs have to partake in order to access the rest of the local funding. 

PCNs have been asked to share a ‘costed access improvement plan’ in the first quarter of this financial year, outlining how it will use the funding.

There are also requirements around ‘turnaround’ times and ‘continuity’, meaning practices must:

• Code all clinical contacts (incl. GP appointments) in the ledger to ‘demonstrate change in line with plan’;
• Respond to 90% of calls within 10 minutes;
• Respond to online consultations within one working day;
• Ensure the ‘top 2% of high-risk patients are flagged for continuity of care’;
• Increase NHS App registration by 10% (or agreed local target where uptake is already above 75%).

In February last year, Pulse exclusively revealed that the ICB was planning to effectively mandate the use of same-day access hubs – leaving GP practices with only ‘complex’ care – by introducing the requirement as part of its single offer.

But after shelving the plans the following month due to criticism from GPs and patients, the ICB committed to finding a way to direct the £6.6m of funding intended for the hubs in 2024/25 back into general practice. 

Earlier this year, Pulse reported that GPs were asked to come up with plans to increase ‘activity’ by at least 10% in order to access the funding, with the LMC concerned that the money may be lost due to ICB delays.

Now, a document setting out the ICB’s access programme over the last two years has revealed that just over 80% of the £6.6m was allocated to general practice via this process in 2024/25.

Pulse has asked the ICB to clarify where the unused £1.2m was spent, since in February local commissioners refused to confirm that the money would be ringfenced for general practice as it was ‘dependent’ on successful bids from PCNs. 

The ICB’s most recent update revealed that 6 out of the 44 PCNs that bid for the money were unsuccessful, and it also indicated that PCNs ‘serving more deprived populations missed out on funding’. 

Across PCNs that won their bids, there was a projected increase in ‘activities’ of over 253,000 in the last quarter of 2024/25, which the ICB said meant patients are 12% ‘more likely to access a primary care service’. 

For 2025/26, the ICB said the £6.6m access specification ‘has now been included within the NWL Enhanced Services Single Offer’ in order to ‘provide a consistent, equitable set of enhanced services to all patients’ across the patch. 

Local commissioners also emphasised the importance of PCNs having flexibility to develop their own models based on local need, recognising that the initial same-day hub model met with strong criticism. 

‘The plans were not well-received and received considerable challenge on the basis Practices and patients felt that the ICB was trying to impose a one-size-fits-all approach onto 350 Practices that all had different starting points and different demographics,’ the document said. 

Pulse has approached NWL LMC for comment on the new 2025/26 specification. At the end of March, local leaders said the ICB had handled the process ‘professionally’ this time, with ‘responsiveness to LMC suggestions’.

‘The KPIs seem achievable, and discussions are ongoing to ensure the template proposal is not onerous and any data created can be meaningfully used to improve patient care,’ the LMC newsletter said.