The LMC recently met with colleagues from local provider services to discuss proposed changes within one of the specialist nursing pathways. Although the immediate example related to diabetes care, the discussion highlighted a broader pattern that affects several services.
Some recent communications have suggested that elements of specialist management – such as insulin adjustment – could be undertaken within general practice, supported by training or “upskilling” offers. While these initiatives are often well‑intentioned and aimed at improving patient access, they can unintentionally create expectations that practices will take on additional activity that sits outside the core GP contract.
To ensure clarity and consistency across the system, we want to emphasise the following:
This applies to insulin titration but also to any other specialist activity that may be proposed as part of service redesign.
Upskilling can be valuable, but it does not replace the need for properly commissioned services. Practices should be mindful that well‑meaning staff may feel inclined to take on additional tasks that are not funded or supported.
Where a patient requires specialist intervention, referral to the appropriate service remains the correct pathway unless formal changes are agreed and resourced.
We have asked for assurance that any proposed changes to pathways or responsibilities will be discussed transparently, with full consideration of workload, training, indemnity, and resource implications.
Every year we receive questions from practices about how the annual pay uplift should be applied to salaried GPs. The right approach depends on the type of contract in place, so it’s helpful for practices to be clear about their obligations and flexibilities before making any decisions
This flexibility is important for practices managing tight budgets, but it should be exercised carefully and with clear communication.
It is worth noting that the GMS contract uplift this year is slightly higher than the expected pay award. This means:
Please see the message and request from Cheryl Gowland, GP Liaison at RDaSH.
One of our ambitions at RDaSH is to strengthen communication and collaboration with our GP practices.
You may recall that just over 12 months ago we appointed the role of GP Liaison and asked all of our GP practices what their perception of RDaSH was and how they rated our relationship at that time.
During the last 12 months we have become much clearer about where the pressure points exist for our GP colleagues and have started to align some of our own priorities to this insight. During this time we have also appointed GP experts into roles working directly with services and to sit on our Board providing the organisational leadership required to help influence change.
Acknowledging the work we still need to do, we are asking you to reflect on your own experience and to let us know if things feel any different now or if you have been relieved of some of those pressure points.
Please feel free to share across your practice teams or wider networks where appropriate (eg ICB, Federation, LMC, etc) so that we can capture a number of different perspectives. The survey should take between 5 and 8 minutes to complete (the longer responses are optional but would give us some really useful insight if you do have the time). Responses will be used to inform further service improvement. It would be appreciated if you could complete the survey by Thursday, 30 April 2026.
NHS England has confirmed the introduction of two new obesity indicators into the 2026/27 QOF framework. Together they represent a significant expansion of QOF into the management of obesity, reflecting both the scale of the public health challenge and the arrival of new pharmacological treatments. These indicators sit within the Public Health domain and carry a combined total of 18 points.
What practices should do
Until commissioning is confirmed:
This approach ensures compliance with QOF while maintaining transparency about local service limitations.
Once Doncaster ICB commissions Mounjaro as a LES, practices will be able to prescribe tirzepatide for eligible cohorts under NICE guidance and integrate medication initiation into the shared decision‑making workflow. The LMC will update practices as soon as commissioning arrangements are confirmed.
In the meantime, practices should focus on accurate coding, timely referrals, and structured documentation. These remain the key elements for meeting QOF requirements and supporting patients effectively while local pathways are finalised.
For further information follow this link to the LMC Website:
Tirzepatide (Mounjaro®) Kwikpen in adults 18 years and over with type 2 diabetes mellitus, amber G guidance document V2.0 has been updated and approved at the IMOC meeting . The update included an update to the pancreatitis, orlistat and retinopathy sections and addition of the flow chart from PCDS as an appendix.
QOF 2026/27 continues the steady simplification we’ve seen over recent years – but this round brings some meaningful refinements that practices will want to understand.
Several indicators have been merged, retired, or adjusted, with thresholds reshaped to reflect what is realistically deliverable in day‑to‑day general practice. Long‑term condition management remains at the heart of the framework, but this year introduces:
The overall points total remains unchanged, and there is a modest inflationary uplift, but the real intention is clear:
reduce administrative burden while strengthening the quality of care that matters most.
If you want to see the full breakdown – including indicator changes, QI expectations, and what this means for practice workload and income – you can read our full summary here:
The 2026/27 Network Contract DES brings one of the most significant shifts we’ve seen in recent years – not just in funding, but in how PCNs can shape their workforce, organise their footprint, and demonstrate access and continuity.
This year’s DES introduces major reforms to ARRS, including:
Alongside this, practices will see modest uplifts across core funding, Enhanced Access, ARRS, and Care Home Premiums.
But the changes go beyond finance. PCNs will be expected to:
Meanwhile, the Capacity & Access Payment is being retired, replaced with a new practice‑level GP reimbursement scheme designed to simplify the process.
What hasn’t changed is the core access expectation:
clinically urgent patients must still receive a same‑day response.
If you want the full breakdown – including what this means for your PCN, your workforce planning, and your financial position – you can read our detailed summary here:
From Wednesday 15th April 2026, all Discharge Summaries from DBTH Emergency Departments and Minor Injuries Units will be sent electronically via MESH mailbox. This will fully replace the previous paper‑based process.
PR Capacity Planning Tool
The Pulmonary Rehabilitation Capacity Planning Tool is now available on the NRAP website. The tool is intended to provide information on the projected number of patients with Chronic Obstructive Pulmonary Disease (COPD) in a chosen locality who are likely to progress through the Pulmonary Rehabilitation pathway and use QOF, CPRD and NRAP data.
Spirometry training e-learning modules
Developed in partnership with the Association of Respiratory Technologists and Physiologists, the Performing and Interpreting Spirometry Programme consists of 6 e-learning sessions that enhance understanding of how spirometry is conducted and how results should be interpreted. The programme is designed for a national, multi-professional audience involved in respiratory diagnostics, including staff in primary care, community services, and other clinical environments where spirometry is undertaken. The e-learning can be accessed on the NHS learning hub or via the spirometry commissioning standards (annex C)
Spirometry data capture template
An excel template has been designed to support a standardised approach to capturing spirometry data and related clinical information in primary care. Designed collaboratively by NHS England, respiratory clinical leads, and partners including ALUK, NICE, BTS, the Respiratory Data Science Catalyst, and PCRS, the template aims to support best practice and quality assurance in respiratory diagnostics. The template has been added as an annex to the spirometry commissioning standards and can also be accessed via our NHS Futures pages.
Please direct questions to england.clinicalpolicy@nhs.net
Children and young people under 18 should be referred to RDaSH CAMHS Eating Disorder Services.
Referral information:
Child and Adolescent Eating Disorders – Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH)
SYEDA can accept:
Referral information:
SYEDA – South Yorkshire Eating Disorder Association
Refer to CMHT where:
Specialist clinicians with eating disorder expertise are available within the CMHT team.
Referral information:
Adult Community Mental Health – RDaSH
SEDS accepts:
Important:
Copies of required blood tests must be submitted with the referral form for triage.
SEDS currently cannot access ICE results for Doncaster patients, so practices must attach results manually.
Referral information:
Specialist Eating Disorder Service – Sheffield Health and Social Care NHS Foundation Trust
Commissioned ARFID provision in South Yorkshire remains limited.
SYEDA may assess young people under 25 with ARFID who meet their acceptance criteria (including BMI > 17.5).
Doncaster LMC is been a member of the LMC Buying Groups Federation.
Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.
Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.
What is the purpose of the Buying Group and how does it work?
The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.
Does it cost us anything to be part of the group?
No, membership is free and members are free to use as many discounts as they wish.
Is there any obligation to take up the deals offered?
No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.
*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.
What happens to my details?
When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.
What if I am not happy with the quality of goods and services supplied?
Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.
Contact the Buying Group
The Buying Group is managed by Plexus Support Services Ltd:
Tel: 0115 979 6910
Email: info@plexussupport.co.uk
Website: https://www.plexussupport.co.uk
