North Central London Long-Term Conditions Locally Enhanced Service (NCL LTC LES)

Abtrace is making it easier than ever to help achieve your NCL Long-Term Conditions Locally Enhanced Service (LTC LES)

Practices can now automate patient recall in line with NCL guidelines, helping to streamline what has traditionally been a complex area of care.

📋 Introducing NCL Priority Groups into the Proactive Monitoring Tool

The NCL Priority Groups as defined in the 2025 NCL risk stratification document are now available directly within the tool.

These groups have been carefully cross-referenced with EMIS searches to try to achieve as close an alignment as possible with the current standards and definitions. 

You can now view and manage patients within the following Priority Groups directly in the Proactive Monitoring Tool:

Priority Group 1

🔴 High Risk + Complex
Patients with multiple conditions or factors that significantly increase clinical risk.

Priority Group 2

🟠 High Risk
Patients at high risk but not classified as complex.

Priority Group 3

🟡 Medium Risk (Group A/B)
Patients with moderate complexity or condition burden.

Priority Group 4

🟢 Low Risk (excluding certain conditions)
Patients with lower risk profiles, excluding those who only have Asthma, Hypertension, or are Children/Young People (CYP) with Asthma.

Priority Group 5

🔵 Low Risk (Asthma/Hypertension/CYP Asthma only)
Patients whose only conditions are:

• Asthma
• Hypertension
• Children/Young People with Asthma

This update helps practices manage patients step-by-step using the NCL Model of Care carousel. The system will only suggest the next steps once a patient has reached the appropriate stage.

Patients will only be marked as "outstanding" for the appointments that apply to their priority group and stage of care.

Example:
If a patient is in Priority Group 2 and hasn't yet completed their Check and Test, they won’t be flagged for an MDT review.
They’ll continue being recommended appointments only up to the Follow-Up Appointment stage for one year after their Check and Test.

Care Planning (NCL)

The Care Plan (NCL) is also tracked.
This step will only become available after a patient has completed their Check and Test.

To view all outstanding Care Plans (NCL), use this link -

abtrace://population?version=2&search=b8a866636e48447ab49fd9c43f6f1153

Start automating your NCL Model of Care

You can use Indication and Task filters in the Population View to:

• See which patients are in each risk group
• Identify what actions are needed for each one

Patients can also be sent automated self-booking links for the appointments they’re due for.

Below are some example links to help set up possible automated recalls (you may want to add further filters before setting up a recall, such as excluding housebound patients). 

Need a Financial Year View?

If needed, the rules and pathways can be adjusted to follow the financial year. This is available on request.

As always, these documents were created to the best of our clinical abilities, however, we are always looking to improve. If there is anything that doesn’t quite look right, please reach out to your customer support representative at support@abtrace.co