NHS England has reaffirmed the regulatory framework permitting sub-contracting—and onward sub-contracting—of clinical services under the Network Contract Directed Enhanced Service (DES) for Primary Care Networks (PCNs). This flexibility allows PCNs to delegate service delivery to third-party providers, provided appropriate contractual arrangements are in place.
For instance, a PCN made up of core member practices may choose to sub-contract the provision of certain clinical services to a local GP Federation or other qualified healthcare provider. Such arrangements can support operational efficiency, workforce flexibility, and improved service delivery across the network.
To support this process, NHS England has released a revised sub-contract template aligned with the 2025/26 DES specification. This updated template is designed to ensure that any sub-contracting agreements meet regulatory standards and clearly define responsibilities, governance, and accountability between the PCN and the subcontractor.
PCNs engaging in or planning to engage in sub-contracting arrangements are strongly encouraged to review and utilise this updated template to ensure compliance and safeguard service quality.
Benefits of Subcontracting:
Flexibility in Service Delivery: Subcontracting allows PCNs to engage experienced third-party providers, such as GP Federations or specialist organisations, which can enhance capacity and access.
Efficient Use of Resources: Delegating specific services can reduce duplication, streamline operations, and make better use of the PCN’s collective workforce and infrastructure.
Improved Service Coverage: Subcontracting may enable wider geographical coverage and extended service hours, helping PCNs meet patient needs more effectively.
Access to Specialist Skills: Subcontractors may offer niche expertise or established service models that PCNs can leverage to improve clinical outcomes.
Considerations and Risks:
Governance and Accountability: Clear roles, responsibilities, and lines of accountability must be established through robust contractual arrangements.
Quality Assurance: PCNs must ensure subcontracted services meet the same standards as those delivered in-house, with appropriate monitoring and performance management in place.
Financial Oversight: Subcontracting introduces an additional financial relationship that requires careful oversight to avoid cost overruns or value-for-money concerns.
Continuity of Care: Transferring services to external providers may risk fragmentation if not well integrated with core PCN operations and patient pathways.
PCNs are advised to weigh these factors carefully and use the revised NHS England sub-contract template to formalise any arrangements.
You can access the revised sub-contract template and accompanying guidance via this link.
The NHS has introduced a new national plan for how local NHS organisations will work in the future. These organisations are called Integrated Care Boards, or ICBs for short. The plan is known as the Model ICB Blueprint. It has been developed by NHS England together with leaders from ICBs across the country and is intended to prepare the NHS for a new way of planning and funding services, especially ahead of the upcoming 10-Year Health Plan.
The main aim of this blueprint is to help people live longer and healthier lives. The focus is on improving the health of the population, reducing unfair differences in care between different communities, and making sure that the NHS delivers high quality care in a way that is affordable and efficient.
ICBs will stop being involved in delivering services themselves and instead will act as strategic commissioners. This means they will make decisions about what services are needed, who should deliver them, and how success should be measured. They will use data and forecasting tools to understand what people in their area need, plan long-term strategies in partnership with local communities, and work to prevent illness wherever possible. Care will be organised around people’s needs rather than buildings or budgets. ICBs will also adopt a new way of paying for care that is based on what services should cost and what results they achieve, not just how many appointments or treatments are provided.
There are specific targets and deadlines that ICBs must meet. One of the most important is that they must reduce their running costs to no more than £18.76 per person by the third quarter of the 2025/26 financial year. They must send detailed cost-saving plans to NHS England by 30 May 2025. To meet these requirements, ICBs will have to simplify their structures. Some jobs and responsibilities—such as emergency planning, continuing healthcare, digital leadership, safeguarding, and support for primary care—will be moved out of ICBs and into local providers or NHS regional teams. NHS England has said that some ICBs may need to merge or share leadership teams with other areas to save money and reduce duplication.
ICBs will also be expected to use outcome-based contracts. This means that contracts with providers, including general practice, will be linked to the results they deliver—such as improvements in health, patient experience, and access to care—rather than just the number of services provided. Services will be monitored using real-time data and feedback from patients and communities, with particular attention paid to whether they are helping reduce health inequalities.
These changes will have a direct impact on general practice. General practice will be expected to work more closely with other local services and play a leading role in planning and delivering care pathways, for example in areas such as frailty, wound care, long-term conditions, and urgent care in the community. GP practices will need to demonstrate how the care they provide helps improve patient outcomes. The use of digital tools will become essential, with all practices expected to connect to the NHS Federated Data Platform, which will become the national system for analysing and sharing data across health services.
Contracts for general practice and other services will be based on “should cost” models. These are pricing tools that estimate what a service should cost based on local population needs, the expected outcomes, and evidence about best practice. These models are designed to create fairer and more consistent funding decisions across the NHS.
In response to all these changes, Doncaster Local Medical Committee (LMC) will take several important steps. It will make sure that general practice is properly represented in all discussions about how services will be planned and funded. It will closely monitor how changes affect GP workloads, funding, and staffing. The LMC will help GP practices across Doncaster build stronger partnerships and collaborations, so that they are well placed to take on wider service responsibilities when it makes sense to do so. It will also work with the ICB and NHS England to make sure that the outcomes used to judge services are realistic and take into account the challenges faced by practices serving deprived or underserved communities. Doncaster LMC will support practices in preparing for the digital transformation, ensuring that the required tools are user-friendly, secure, and funded properly. Finally, the LMC will continue to fight for fair, clear, and sustainable contracts that reflect the real cost of providing high-quality general practice.
In summary, the Model ICB Blueprint sets out a future NHS that is more joined-up, more focused on outcomes, and more locally led. Integrated Care Boards will become smaller and more strategic. Operational work will move to providers. Services will be funded based on results, not just activity. General practice will need to adapt, but it also has a vital role to play in making this future NHS a reality. Doncaster LMC will continue to support and advocate for local GPs every step of the way.
The NHS has introduced a new national plan for how local NHS organisations will work in the future. These organisations are called Integrated Care Boards, or ICBs for short. The plan is known as the Model ICB Blueprint. It has been developed by NHS England together with leaders from ICBs across the country and is intended to prepare the NHS for a new way of planning and funding services, especially ahead of the upcoming 10-Year Health Plan.
The main aim of this blueprint is to help people live longer and healthier lives. The focus is on improving the health of the population, reducing unfair differences in care between different communities, and making sure that the NHS delivers high quality care in a way that is affordable and efficient.
ICBs will stop being involved in delivering services themselves and instead will act as strategic commissioners. This means they will make decisions about what services are needed, who should deliver them, and how success should be measured. They will use data and forecasting tools to understand what people in their area need, plan long-term strategies in partnership with local communities, and work to prevent illness wherever possible. Care will be organised around people’s needs rather than buildings or budgets. ICBs will also adopt a new way of paying for care that is based on what services should cost and what results they achieve, not just how many appointments or treatments are provided.
There are specific targets and deadlines that ICBs must meet. One of the most important is that they must reduce their running costs to no more than £18.76 per person by the third quarter of the 2025/26 financial year. They must send detailed cost-saving plans to NHS England by 30 May 2025. To meet these requirements, ICBs will have to simplify their structures. Some jobs and responsibilities—such as emergency planning, continuing healthcare, digital leadership, safeguarding, and support for primary care—will be moved out of ICBs and into local providers or NHS regional teams. NHS England has said that some ICBs may need to merge or share leadership teams with other areas to save money and reduce duplication.
ICBs will also be expected to use outcome-based contracts. This means that contracts with providers, including general practice, will be linked to the results they deliver—such as improvements in health, patient experience, and access to care—rather than just the number of services provided. Services will be monitored using real-time data and feedback from patients and communities, with particular attention paid to whether they are helping reduce health inequalities.
These changes will have a direct impact on general practice. General practice will be expected to work more closely with other local services and play a leading role in planning and delivering care pathways, for example in areas such as frailty, wound care, long-term conditions, and urgent care in the community. GP practices will need to demonstrate how the care they provide helps improve patient outcomes. The use of digital tools will become essential, with all practices expected to connect to the NHS Federated Data Platform, which will become the national system for analysing and sharing data across health services.
Contracts for general practice and other services will be based on “should cost” models. These are pricing tools that estimate what a service should cost based on local population needs, the expected outcomes, and evidence about best practice. These models are designed to create fairer and more consistent funding decisions across the NHS.
In response to all these changes, Doncaster Local Medical Committee (LMC) will take several important steps. It will make sure that general practice is properly represented in all discussions about how services will be planned and funded. It will closely monitor how changes affect GP workloads, funding, and staffing. The LMC will help GP practices across Doncaster build stronger partnerships and collaborations, so that they are well placed to take on wider service responsibilities when it makes sense to do so. It will also work with the ICB and NHS England to make sure that the outcomes used to judge services are realistic and take into account the challenges faced by practices serving deprived or underserved communities. Doncaster LMC will support practices in preparing for the digital transformation, ensuring that the required tools are user-friendly, secure, and funded properly. Finally, the LMC will continue to fight for fair, clear, and sustainable contracts that reflect the real cost of providing high-quality general practice.
In summary, the Model ICB Blueprint sets out a future NHS that is more joined-up, more focused on outcomes, and more locally led. Integrated Care Boards will become smaller and more strategic. Operational work will move to providers. Services will be funded based on results, not just activity. General practice will need to adapt, but it also has a vital role to play in making this future NHS a reality. Doncaster LMC will continue to support and advocate for local GPs every step of the way.
In light of the recently agreed changes to the General Medical Services (GMS) contract for 2025/26, NHS England has published a document setting out how these changes will be reflected in Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts.
This guidance outlines the funding adjustments NHS England will apply to ensure consistency across contract types, maintaining parity and fairness in resource distribution. It explains the methodology used to translate national GMS funding uplifts into equivalent changes for PMS and APMS providers, including adjustments to baseline payments, service expectations, and any specific funding elements such as the global sum equivalence and quality payments.
The document is intended to provide clarity for commissioners and contract holders, helping practices understand how their funding will be affected in the upcoming financial year. Practices operating under PMS and APMS contracts should familiarise themselves with the contents of this document to support effective financial planning and contract management.
To access the full document and further details, please follow this link.
NHS England has released a formal communication from Ben Day, Director of Financial Strategy and Payments, outlining the financial implications associated with the General Practice (GP) contract agreements for the 2025/26 financial year.
This letter provides essential information for practices and commissioners, detailing how the agreed contractual changes will be funded and implemented. It includes updates on global sum allocations, funding for additional roles, changes to payment mechanisms, and any adjustments linked to inflation or service expectations.
The document is a key resource for understanding how national financial strategy translates into local funding arrangements and is intended to support practices in planning for the year ahead.
Practices are encouraged to review the letter in full to ensure they are aware of the latest funding details and can assess how these changes may affect their financial planning and service delivery.
You can access the letter and related documents on the NHS England website or via this link.
NHS England has published an updated income ready-reckoner for practices and primary care networks.
Any organisation that currently has a contract with PCC can apply for up to £3,000 of free PCC support. The support must be used to help local communities with one or more of the following:
They offer a wide range of support. For more information on their services visit https://www.pcc-cic.org.uk/. Download an application form to apply.
The British Medical Association (BMA) has now published its official guidance on Shared Care Prescribing. This document outlines the principles that govern how prescribing responsibilities are shared between specialist services and general practice.
What is Shared Care Prescribing?
Shared care prescribing refers to an arrangement where a specialist initiates a patient’s medication and then shares the responsibility for ongoing prescribing and monitoring with a GP practice. This process is usually guided by a formal Shared Care Agreement, which sets out the expectations, responsibilities, and clinical governance arrangements for both parties.
Key Principles of Shared Care Prescribing:
Voluntary and Non-Core
Shared care is not part of core general practice services. It is entirely voluntary, and GP practices have the right to decline participation in shared care arrangements for any reason.
Confidence in Specialist Governance
A GP practice must be satisfied with the quality assurance, clinical governance, and accountability mechanisms of the initiating specialist provider before agreeing to participate.
Clear Monitoring Responsibilities
Where ongoing monitoring of medication is required, the responsibilities must be explicitly detailed within the associated guidance or shared care agreement, ensuring clarity and safety for patients and clinicians alike.
Stabilisation Before Handover
Before prescribing responsibility is transferred to the GP practice, there must be an appropriate stabilisation period during which the specialist confirms the patient’s treatment is effective and well-tolerated.
Ongoing Specialist Involvement
The arrangement must include ongoing, accessible input from the specialist, to support the GP practice in managing the patient’s care safely and effectively.
Commissioned and Funded Pathways
Any additional workload undertaken by the GP practice – such as blood monitoring, tests, or frequent reviews – must be part of a funded, commissioned pathway. GPs should not be expected to absorb this work within routine practice without appropriate resources.
For further detail and practical advice, please review the full guidance:
👉 Doncaster LMC – Shared Care guidance
👉 Prescribing in General Practice – BMA Guidance
Any organisation that currently has a contract with PCC can apply for up to £3,000 of free PCC support. The support must be used to help local communities with one or more of the following:
They offer a wide range of support. For more information on their services visit https://www.pcc-cic.org.uk/. Download an application form to apply.
The British Medical Association (BMA) has now published its official guidance on Shared Care Prescribing. This document outlines the principles that govern how prescribing responsibilities are shared between specialist services and general practice.
What is Shared Care Prescribing?
Shared care prescribing refers to an arrangement where a specialist initiates a patient’s medication and then shares the responsibility for ongoing prescribing and monitoring with a GP practice. This process is usually guided by a formal Shared Care Agreement, which sets out the expectations, responsibilities, and clinical governance arrangements for both parties.
Key Principles of Shared Care Prescribing:
Voluntary and Non-Core
Shared care is not part of core general practice services. It is entirely voluntary, and GP practices have the right to decline participation in shared care arrangements for any reason.
Confidence in Specialist Governance
A GP practice must be satisfied with the quality assurance, clinical governance, and accountability mechanisms of the initiating specialist provider before agreeing to participate.
Clear Monitoring Responsibilities
Where ongoing monitoring of medication is required, the responsibilities must be explicitly detailed within the associated guidance or shared care agreement, ensuring clarity and safety for patients and clinicians alike.
Stabilisation Before Handover
Before prescribing responsibility is transferred to the GP practice, there must be an appropriate stabilisation period during which the specialist confirms the patient’s treatment is effective and well-tolerated.
Ongoing Specialist Involvement
The arrangement must include ongoing, accessible input from the specialist, to support the GP practice in managing the patient’s care safely and effectively.
Commissioned and Funded Pathways
Any additional workload undertaken by the GP practice – such as blood monitoring, tests, or frequent reviews – must be part of a funded, commissioned pathway. GPs should not be expected to absorb this work within routine practice without appropriate resources.
For further detail and practical advice, please review the full guidance:
👉 Doncaster LMC – Shared Care guidance
👉 Prescribing in General Practice – BMA Guidance
In response to frequent inquiries from practices regarding the distinction between mandatory and non-mandatory forms, we have made a significant update to our advice on this matter. We understand that navigating these requirements can often be confusing, and we aim to provide clarity to help practices comply with the various regulatory and operational needs.
Mandatory Forms: These are forms that are legally required or essential for practices to complete to ensure compliance with various healthcare regulations, contracts, and funding requirements.
Non-Mandatory Forms: These forms, while useful, are not strictly required. However, they can support practices in improving their operations or meeting specific local or organisational needs.
For further details, please visit our dedicated pages:
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
