Driving Local Enhanced Services Income Across Hillingdon through IAP Optimisation
Introduction
Practices in North West London have long struggled to maximise income from Local Enhanced Services (LES) due to the complexity of coding requirements, fragmented workflows, and inconsistent data capture. Primary Care IT was commissioned within Hillingdon to support practices and PCNs across the borough with intelligent tools and hands-on guidance to ensure every eligible activity was accurately captured, coded, and claimed. This case study showcases the dramatic financial uplift achieved in the last year of this collaboration.
Background/Challenge
LES activity — including spirometry, phlebotomy, ECGs, ambulatory blood pressure monitoring, and near patient testing — is often under-recorded due to human error, coding complexity, or lack of visibility.
Challenges included:
- Missed income from uncoded or mis-coded clinical activity.
- Lack of tools to flag eligibility or prompt correct documentation.
- Limited insight into practice and PCN performance against contractual opportunities.
The aims of this project were to:
- Provide real-time insight into performance and missed opportunities.
- Automate detection of eligible work to reduce admin burden.
- Maximise income through improved data quality and staff support.
Solution
Primary Care IT implemented a complete IAP (Income & Activity Performance) toolkit for practices and PCNs, including:
- Smart Data Entry Templates
Tailored templates streamlined the capture of activity at the point of care — ensuring that clinical and billing requirements were met in one go. - Automated Alerts and Protocols
These flagged coding errors, incomplete entries, or missed opportunities — for example, highlighting when wound care, ABPM or DOAC activity should be recorded for income. - OneAnalytics Dashboards
Live dashboards showed practices where they stood against LES benchmarks and exactly how much income they had unlocked — or were at risk of missing.
Monthly Narrative Reports
Bespoke written summaries helped each PCN prioritise, with hints and tips for improvement, and a focus on high-value areas like near patient testing and spirometry.
Outcome
The impact was dramatic — and far outstripped regional averages:
- Practices supported by PCIT achieved £11.44 per weighted patient, compared with an average of £7.02 across the wider NWL ICB.
- This represents an uplift of £4.43 per patient, or £1,230,829.09 additional income secured across participating PCNs.
- Every PCN supported by PCIT gained at least £200,000 in additional income from improved coding, insight, and performance.
- Standout improvements were seen in spirometry and near patient testing, where real-time tools prompted clinicians and unlocked high volumes of previously unclaimed activity.
This is seen most strikingly in a graph comparing PCIT PCNs with others in the NWL ICB:
Conclusion
Primary Care IT’s IAP approach delivered exceptional financial results across Hillingdon — with over £1.2 million in additional LES income secured through targeted digital tools, training, and live performance reporting.
This success demonstrates the transformative impact of aligning clinical activity with digital insight — and provides a scalable model for any NWL ICB or PCN seeking to enhance the value of local enhanced services.