GP practices have been urged not to sign any new contracts with NHS England or local ICBs while the BMA’s GP committee ‘explores new opportunities’ with the Government.
This action has now been added to the menu of options that practices could take as part of potential collective action, coordinated by GPC England and planned for 1 August, depending on the results of a ballot of partners.
During a roadshow in London last week, GPCE deputy chair Dr Samira Anane explained that as part of collective action, practices should ‘defer’ making ‘any decisions’ of signing new contracts while the union explores new opportunities with ministers.
She said that this refers specifically to pilots announced by NHS England in May, through which PCNs and ICBs are going to trial ‘new ways of working’ for GP practices.
As part of the pilots, 15 PCNs in seven ICBs around the country will test new ways of using ‘more flexible staffing models’, data, and process automation within general practice, but NHS England did not go into detail about what the pilots will entail for GP practices.
Dr Anane said: ‘Defer making any decisions signing new NHS England or ICB contracts whilst we explore new opportunities with the new government. And this is basically code for the new PCN pilots that are coming up.
‘Instead of investing in core general practice, we’re having these little pots of funding that practices are having to chase with lots of caveats. We should be having core funding in the core contract.’
She said that general practice now has ‘a new opportunity’ with the new Government and pointed out that GPC chair Dr Katie Bramall-Stainer met with health secretary Wes Streeting last week.
She said: ‘Let’s put this on hold. Let’s look at what we need, rather than signing up and tying ourselves into something that actually longer term might do us harm.’
The GPC said it is up to practices to choose which actions to take from the menu of actions and it will be ‘inviting GP partners to work with their practice management team’ and their LMC to ‘determine the actions they will be willing to take’.
The committee indicated that this will be a ‘first phase’ of action, and that ‘further escalation’ beyond a non-statutory ballot can be stopped if the Government agrees to make ‘contractual improvements’ in 2024/25 and restore GP funding to 2018/19 levels.
But ‘phase two’ could involve ‘escalation’ to contract breach actions, ‘action short of strike’ and ‘strike action’, which may include salaried GPs, registrar GPs and or other practice staff.
It follows a referendum by the GPC which found that 99% of GPs did not agree with the recent contract imposition, as well as the committee officially declaring a ‘dispute’ with NHS England.
During the roadshow, when asked if GPs could potentially walk out in the same way as consultants and junior doctors have done, Dr Anane said that ‘we’re not to say that we may not walk out’ but that ‘there is an opportunity’ to prevent it.
She said: ‘What’s important is that every footing that we take is very sure and not on shaky ground, because if we do that, we will be going three steps backwards.
‘So we’re not to say that we may not walk out. But there is an opportunity to prevent that escalation, and we’d welcome that because we want solutions.
‘One other thing we need to say is we are not employees of the NHS as our hospital colleagues. Therefore, the rules and the systems that govern us are not the same.
‘It might be very sexy to go out with placards and in big numbers, but actually, as GPs, we know that the position that we hold is very different to our hospital colleagues, and that may not achieve the aim.’
The GPC presented its ‘vision’ for the future of general practice during the roadshow, including a goal for practices to have a list size of up to 1,000 patients per GP to ‘ensure safety’.
The vision document, published today following the launch at the roadshow, also includes the demand for the creation of a ‘two-year funded GP fellowship post-CCT practice-level reimbursement scheme’ to enable the recruitment and retention of additional GP roles ‘from the hundreds of unemployed young GPs’.
This should be created ‘as soon as possible within the current financial year’ and funding for this could potentially be reallocated from a review of the Additional Roles Reimbursement Scheme (ARRS), historic ARRS underspend or NHSE transformation schemes, the document added.
