Why should ICB Commissioners use CQRS Local to manage Local Enhanced Service claims?

Local Enhanced Services (LES) give Integrated Care Boards (ICBs) a way to commission services outside of the national GP contract, in response to the health needs of local populations.

Commissioners need a reliable way to manage provider participation of LES, receive and check claims for services delivered, validate evidence supplied, and approve payments, while maintaining a clear audit trail.

Issues with manual claims management systems

Managing this process through spreadsheets and emails can be time-consuming and difficult to audit. Without a dedicated system, commissioners may find themselves maintaining spreadsheets to track:

• Which practices are participating
• What each practice is entitled to claim
• Claims received and their status
• Supporting evidence
• Approvals and payments
• Outstanding or rejected claims

As the number of locally commissioned services increases, keeping this information accurate and up to date can take significant administrative resources.

A standardised approach to claims management

CQRS Local is a NHS-funded system designed to reduce the time commissioners spend managing local service delivery claims by providing a consistent approach to configuration and administration. This means commissioning teams can spend less time managing the process of the claims and more time focusing on commissioning services.

Using a common platform for local claims provides greater consistency in how those services are configured and administered, supporting different specifications and evidence requirements for different schemes.

One of the key benefits of CQRS Local is having a centralised, web-based platform through which local claims can be submitted, reviewed and managed. For an ICB, this creates a more structured process from submission through to approval and payment.

Instead of relying on email trails and locally maintained spreadsheets, commissioners access a web-based, centralised record of claims. This can make it easier to see what has been submitted, what requires action, and where a claim sits in the approvals process.

Clear responsibilities for managing claims

CQRS Local supports role-based access, with different commissioner roles reflecting different responsibilities within the claims process.

Roles include:

Administrator – manages CQRS Local accounts including setting up commissioner users and provider accounts.

Approver – Tier 1 – checks claims are submitted by GP practices and includes reviewing supporting evidence and vetting submissions.

Approver – Tier 2 – approves claims financially and submission of claims for payment.

Finance (optional) – approves claims that exceed specified financial values.

These roles help establish a clear workflow and ensures responsibility for checking and approving claims.

Clear audit trail and assurance

Being able to demonstrate how public money has been managed is fundamental for ICBs. CQRS Local supports this by providing a clear record of submissions, checks and approvals.

Visibility of how primary care services are delivered

The information generated through claims for LES can help commissioners understand how a service is being delivered across their region or an area.

CQRS Local provides increased reporting functionality and the ability to view variations in practice activity and uptake across the region. This turns the claims process into a useful source of operational intelligence, rather than simply an administrative tool.

Making local commissioning easier to manage

LES’s are designed to address local population health priorities. The system used to administer these schemes should therefore make it easy for commissioning teams to manage claims for delivery.

CQRS Local provides a dedicated platform for managing local claims with access to external system support.

For ICBs looking to move away from manual processes and establish a more consistent approach to LES claims, CQRS Local provide the infrastructure needed.

Why choose CQRS Local to manage LES claims

In summary, CQRS Local helps commissioners reduce the administrative burden of managing LES claims by:

• Reducing reliance on spreadsheets and email-based processes
• Improving visibility of claims, approvals and payments
• Strengthening auditability and financial governance
• Standardising administration across multiple services
• Supporting robust review and approval through role-based access
• Gaining valuable insight into service delivery and uptake
• Scaling local claims management across multiple GP practices