LMC guidance

15 February 2026

Enhanced Services 2026/27

A service-by-service financial review of this year’s Lothian enhanced services, with a value-for-money verdict on each — from care homes and extended hours through to minor injuries, minor surgery, palliative care and phlebotomy. Practices are encouraged to assess the business case for every service using the BMA calculator before signing up, since inadequately funded services divert time and workforce away from core General Practice.

Also restates the LMC’s position on the cancelled diabetes LES: non-GMS work remains non-GMS unless the contract is formally amended — time-limited LES funding does not permanently redefine core GMS.

24 August 2025

Shared care agreements

Sets out the contractual position on SCAs: they are not part of core GMS, participation is voluntary, and any practice can cease an agreement with responsibility returning to the board — a position confirmed in writing by the BMA. For practices considering change, it works through the practical choices: drawing a line at new patients versus stopping altogether, giving reasonable notice, communicating your reasons clearly, and applying a fair and consistent approach that stands up to equality-duty scrutiny.

27 January 2025

Private providers

A practical approach to requests arising from patients using private healthcare, as long NHS waits push more people to the private sector. Covers sharing information with patient consent, documenting privately prescribed medication, organising tests (outside the scope of NHS primary medical services unless the GP is the responsible doctor), and referring patients back to the NHS. Includes six questions to work through before entering any private shared care agreement — if the answer to any is no, it is appropriate to decline — plus routes for raising patient safety concerns about private prescribers.