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ICBs takes over LES commissioning role from NHSE, guidance confirms

by Jess Hacker
13 September 2023

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Integrated care boards (ICBs) can now commission local enhanced services (LESs), with the BMA urging commissioners  to engage with GPs.

Updated guidance, published by NHS England, has now clarified that ICBs will inherit the commissioning responsibility from NHSE as part of its wider delegation agreement.

Responsibility for commissioning LESs had sat with NHS England since the demise of primary care trusts in 2013, with clinical commissioning groups (CCGs)charged with commissioning community-based services using NHS standard contracts.

The new guidance outlines that NHSE’s delegation agreement includes an ‘amendment that makes clear ICBs delegated primary medical care responsibilities now include decisions on local enhanced services and local incentive schemes’.

It added: ‘This change essentially repatriates the GP contracting and local commissioning responsibilities that existed with primary care trusts prior to NHS England.’

NHS England also clarified that ICBs are free to carry over LESs inherited from CCGs that were commissioned under NHS standard contracts.

However, ICBs are now free to make their own LES arrangements through ‘contractual variation of existing primary medical care contracts’.

Commenting on the clarification, deputy chair of the BMA’s England GP Committee, Dr Julius Parker, said: ‘It makes sense for ICBs to be responsible for commissioning local enhanced services (LES) and local incentive schemes (LIS) – this should simplify regional processes for introducing them.

‘However, it’s essential that LESs and LIS are also negotiated and agreed with the local medical committee (LMC) as these committees represent general practice. LMCs know both their patients and local primary care health priorities. It’s only by fully engaging GPs in local commissioning decisions that we can be sure funding goes to where communities need it the most. These initiatives provide the opportunity to improve patient care efficiently without adding unnecessary workload burden to overstretched practices.’

A version of this story first appeared on our sister title Healthcare Leader