FOI 2026/1718

I am writing to request information regarding any Locally Enhanced Service (LES) schemes offered by your ICB.

1. Does the ICB currently offer a Locally Enhanced Service (LES) incentive scheme—such as those for the management of long-term conditions, targeting of specific patient cohorts, or admission avoidance—to GP practices? If not currently in place, has a scheme of this nature been offered within the past five years?
2. If so, please provide the scheme documentation shared with GP practices and administrators, or detailed information on the scheme’s components, including:

1. • Specific measurement (e.g. anticoagulant monitoring)

1. • Patient cohort (e.g. patients currently taking Warfarin)

1. • Business logic (e.g. QOF-like format), including:

1. • Dataset specification

1. • Patient/cohort selection criteria

1. • Clinical (SNOMED) codes or code clusters

1. • Indicator rules

1. • Reporting template (e.g. a custom template used within the ICB for making a claim)

1. • Funding allocation for the measure (e.g. £1 per head of population, £1 per 1,000 blood clot patients)

3. Please also provide details on the LES operational process from development through to payment claims, including:

a. LES Development

1. • Who is responsible for defining the LES and its business logic?

b. Data Extraction and Submission

1. 1. Who is responsible for preparing the data and submitting it to CQRS?
   2. How is the data prepared and submitted for making a claim (e.g. CQRS portal)? Is the process manual or automated?
   3. How is the reporting template developed and maintained?

c. Payment Process

1. 1. How is the submitted data verified by the ICB or commissioner (e.g. validated against the business logic)? Is this verification manual or automated?
   2. If no formal business logic is applied, how is the data validated?
   3. Are there any audit processes in place? If so, how are these audits conducted?

4. If locally enhanced service incentive schemes are not provided, has the ICB implemented any alternative schemes that supported GP practices with additional funding in the past 5 years?
5. If so, could you please provide the details of those schemes?

1. NHS Greater Manchester (NHS GM) does currently offer a Locally Enhanced Service (LES) incentive scheme to GP practices. The GM specification document for 2026/27 is attached below, together with a slide-deck introducing the scheme.
2. The attached specification document provides the details requested.

3a. The scheme development was developed by subject matter experts across NHS GM commissioning team (including Clinical and Quality leads, Primary Care leads, Medicines Optimisation leads, Elective leads and Neighbourhood Development leads, supported by Data and Intelligence leads and Finance colleagues) in collaboration with the GM Primary Care Collaborative (PCB) GP Board representatives.

3b. Data and reporting

1. Contracted practices are responsible for preparing ensuring that data is available for evaluation and performance management. Largely this is collected through data extraction from GP clinical systems under data sharing agreement arrangements. If the practice has not agreed to data sharing, they are required to provide data reporting.
2. The process for data preparation and submission against is automated (unless the practice has not agreed to data sharing)?
3. The reporting template has been developed by the ICB in the form of Clinical System Searches and reporting through data extraction.

3c. Payment Process

1. Details of payment arrangements are outlined in the attached documents.
2. See response above
3. The scheme is subject to post-payment verification audit and assurance, as detailed in the attached documents.

4. Not applicable
5. Not applicable

**PDF documents were sent to the requester with this response.  If you require a copy of the full response, together with the attachments, please contact NHS GM’s FOI team – nhsgm.foi@nhs.net **