Dear NWL CDs, Thank you for your feedback on the NWL enhanced services offer so far which we are using as part of our ongoing response to the ICB. There remain significant reservations about the potential impact of the proposed contractual model on practice workload. We are currently reviewing the specifications which have been received so far, as well as the financial modelling which has been shared by the ICB in addition to the alliance agreement and contract although there is still some outstanding documentation awaited.
As a reminder, we are holding our monthly NWL CD meeting tomorrow the 14th of February at 1pm where we will be discussing the single offer and continuing to collate views and concerns. If you are not able to attend please continue to feed back by copying in [email protected]<mailto:[email protected]> I look forward to seeing many of you tomorrow, even if you can only attend for part of the meeting. Kind regards, Dr Hannah Theodorou Medical Director Londonwide LMCs Please note my LMC working days are Monday-Wednesday Email: [email protected]<mailto:[email protected]> Web: www.lmc.org.uk<http://www.lmc.org.uk/> From: Lesley Williams via Nwl_cd <[email protected]> Date: Wednesday, 8 February 2023 at 09:11 To: [email protected] <[email protected]> Cc: Lesley Williams <[email protected]> Subject: [Nwl_cd] FW: URGENT ACTION PLS: Your views needed on draft North West London Enhanced Primary Care Services Single Offer for 2023/24 Dear all We would be grateful for your early feedback on the draft single offer sent out by the ICB Friday afternoon. I have attached the papers for ease. Please can you comment on: * The proposed contractual mechanisms * The individual specs * Any additional support needed: for example, infrastructure issues (supporting IT, training etc) if a service will be new to your borough what kind of mobilisation support might you need? Many thanks Lesley Lesley Williams Assistant Director Primary Care Strategy Londonwide LMCs and Londonwide Enterprise Ltd Tel: 020 7387 2034 ext *221 Direct Dial: 020 3818 6221 Mobile: 07768 109690 Email: [email protected]<mailto:[email protected]> Web: www.lmc.org.uk<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.lmc.org.uk%2F&data=05%7C01%7Channah.theodorou%40lmc.org.uk%7C22e47b7742a449d5621008db09b42f56%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C638114442684254477%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=MFC9kRK1AhUaGBnG8uAlFcczZdqaMcARUtcKA3HF80Y%3D&reserved=0> Twitter: @LondonwideLMCs :To view this email as a web page, go here.<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fview.email.lmc.org.uk%2F%3Fqs%3D1e329310c533aee0ceb81d27d83c3fffb12682836930ea80d13363aa73714d13de3e69371c80813b4ec9b5222a7c5937737876c396690365ab2e7b668c5070e6eac766440451f1eb&data=05%7C01%7Channah.theodorou%40lmc.org.uk%7C22e47b7742a449d5621008db09b42f56%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C638114442684254477%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=n0Dq7V20BdhwiCIwbVwB%2FuzRpBPHpwpp5QtEhN2h0sI%3D&reserved=0> [Londonwide Logo] [https://image.s6.sfmc-content.com/lib/ffcf14/m/1/spacer.gif] Tuesday 7 February 2023 Dear Colleague, LMC advice on the draft North West London Enhanced Primary Care Services for 2023/24 including the Equipment MOU On the afternoon of Friday 3 February 2023 Londonwide LMCs were notified by NWL ICB of its intention to share a draft Enhanced Services Contract and associated draft/incomplete documentation with PCNs and practices as a direct response to reported requests received from practices. Your practice will have received a covering letter<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fclick.email.lmc.org.uk%2F%3Fqs%3D7313711935aa58a3fa22ac1fe70d0e5e17f1ae8a3e1993c331e176c3d29a2e449dc7ab22f7e9d17b100be91d32471560&data=05%7C01%7Channah.theodorou%40lmc.org.uk%7C22e47b7742a449d5621008db09b42f56%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C638114442684254477%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=ScNJM7j%2Bp4BkwI8VjPpdVx5G9MKyIgeGs7ywCFs5OAw%3D&reserved=0>, draft contract with specifications<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fclick.email.lmc.org.uk%2F%3Fqs%3D7313711935aa58a3d2c594b3537bec20b37ba85252167381d1205c23406fc6c98bfd014610ac0483172fb24113301153&data=05%7C01%7Channah.theodorou%40lmc.org.uk%7C22e47b7742a449d5621008db09b42f56%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C638114442684254477%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=UMKAOkZ54vHf2cpo8RLr%2F0hcuTS26PrS%2BtPgyP6Cf9k%3D&reserved=0> and draft provider alliance agreement<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fclick.email.lmc.org.uk%2F%3Fqs%3D7313711935aa58a3baa58fb17e392bece45b7c9d3f4c07b3e36fbad84805bd98d31abe497d209736788136f250a4fcc7&data=05%7C01%7Channah.theodorou%40lmc.org.uk%7C22e47b7742a449d5621008db09b42f56%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C638114442684254477%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=mk0NzKmXHVJ5jduk18zzkv6CE6zAQWwCxr0251v9nug%3D&reserved=0> from Javina Sehgal. Please note – these are not for signing. NWL LMCs have requested that they be consulted on the documents in their entirety and have been given assurance that this will take place once the documents have been completed by the ICB solicitors and undergone an ICB review, since the documents are interdependent. As the ICB has stated in its letter, neither its legal team nor the ICB have completed reviewing/writing the draft contract, the draft specifications (one of which is missing) or the draft provider alliance agreement; these are incomplete and subject to change. The ICB has also not provided any information on possible subcontracting arrangements or a risk management framework that will be needed in addition to the provider alliance agreement. You may have noted there is mention of PCNs working together across a borough and/or working with practices outside the borough or PCN. Contractual framework The LMCs are requesting clarification of the ICB statement that the PCN contractual options as set out are required by its Standing Financial Instructions (SFIs): our understanding is that PCNs are not within the scope of the SFIs. The North West London Single Offer Enhanced Services Specifications These have not yet completed LMC review, including the pricing, and the Mental Health Service has not yet been shared. It is not known what will be commissioned or decommissioned at a borough level. These conversations have yet to take place. It is also not clear why borough level services have been referenced in a NWL wide contractual document; this is not appropriate. The Draft Contract and Alliance Agreement Neither is complete; the Alliance Agreement is missing key schedules (eg 6 and 7 relating to financial and workforce frameworks). Supporting infrastructure The LMCs have raised the need for enablers such as training and IT interoperability. Although there is a management cost element in the tariffs there does not appear to be a separate transformation budget, and mobilisation support for areas where these are new services has not yet been clarified. Equipment MOU This was shared with the LMCs but not all LMC comments have been taken on board. Following legal opinion; although the MOU is not legally binding and there is no obligation to sign the ES, Londonwide LMCs is seeking clarification as to what the position would be if a practice took advantage of the funding and then exercised their prerogative and did not sign. What we need from you We would welcome your concerns, queries and comments to [email protected]<mailto:[email protected]> to incorporate in LMCs' feedback. We will keep you updated on progress. 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Think of the environment - Do you really need to print this e-mail? Londonwide Enterprise Limited is a wholly owned subsidiary of Londonwide Local Medical Committees Limited. Registered and office address: Tavistock House South, Tavistock Square, London WC1H 9LG. Registered in England No. 6990874. Londonwide Enterprise Limited is registered as a Company Limited by Shares. VAT no: 130 1454 66. Londonwide Local Medical Committees Limited and Londonwide Enterprise Limited do not provide legal or financial advice and thereby excludes all liability howsoever arising in circumstances where any individual, person or entity has suffered any loss or damage arising from the use of information provided by Londonwide Local Medical Committees Limited and Londonwide Enterprise Limited in circumstances where professional legal or financial advice ought reasonably to have been obtained. Londonwide Local Medical Committees Limited and Londonwide Enterprise Limited provide guidance and support to GPs and practice teams in the Londonwide area. Additionally Londonwide Local Medical Committees Limited provides representation to GPs and practice teams in the Londonwide area. Londonwide Local Medical Committees Limited and Londonwide Enterprise Limited strongly advises individuals or practices to obtain independent legal or financial advice. 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