The second phase of the local enhanced services (LES) review for 2026/27 is continuing in HNY. This is looking at the performance and spend against the 2025/26 agreed LES contracts, and any remaining LES’ across the ICB’s footprint to determine whether they are contracted in the correct way, have been superseded by national contracts, or continue to be required. The areas being reviewed include minor surgery (where a national ES is now in place, removing the need for most local contracts), frailty in one Place, and the use of DomMar and Medicines Record Charts (which are community pharmacy LES’).
The majority of the 25/26 LES’ have been rolled over unchanged. An exception is the phlebotomy LES, which is moving to an activity based banding system. This is to address inequities in the original funding, where all practices received money based on their weighted patient population. Some practices undertook low or very low phlebotomy, while others delivered much higher levels due to factors such as rurality, and proximity to CDCs or local hospitals. The funding envelope has been retained, and practices will now receive payments per blood appointment, with amounts paid increasing based on activity levels. This should support practices whose patients have limited access to other sites for phlebotomy and not provide the same blanket funding even where practices are less active.
Reviews of the Shared Care LES will be undertaken in conjunction with the Area Prescribing Committee as other local and national contract changes impact the list of medications covered by this. You can find separate guidance on shared care and Right to Choose on our website: