England’s GP partners have voted in favour of taking part in collective action in protest against contractual terms and funding.
The non-statutory ballot, which closed on Monday (29 July), saw 98.3% of GP partners voting in favour and 1.7% voting against. In all, almost 8,500 GP partners voted – 67.7% of those eligible.
The action begins today (1 August) and GP practices can choose which out of 10 actions to take from a list of potential options outlined by the BMA.
In the ballot, GP partners were asked if they were ‘prepared to undertake one or more examples of collective action’ as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice.
As revealed by Pulse, the examples include refusing to engage in advice and guidance; limiting patient contacts to 25 a day per GP; and declining to sign new contracts with NHS England or the local ICB.
The BMA will now encourage practice teams to choose actions from the menu, in discussion with their LMC.
This morning, health secretary Wes Streeting announced the Government would temporarily add GPs to ARRS this year as an ’emergency measure’.
However, announcing the ballot result to GPs this morning, GPC England’s chair Dr Katie Bramall-Stainer said: ‘GPs in ARRS is an emergency measure, but we need the new Government to rebuild trust and listen to our sustainable solutions for getting GPs into practices as well as many other suggestions which will support their manifesto commitments.’
The ballot follows a referendum of GPs carried out by GPC England earlier this year, which found that 99% of GPs did not agree with the recent contract imposition. Following this, the committee officially declared a ‘dispute’ with NHS England.
On Tuesday, GPCE deplored the DDRB’s recommendation – accepted by the Government this week – of a 6% pay uplift for partner and salaried GPs as insufficient.
Today, Dr Bramall-Stainer said: ‘The DDRB award is a positive step – but we are still hundreds of £millions worse off in terms of the resources to keep our practices open compared with even five years ago.’
She added that there had been ‘countless opportunities to address the funding crisis in general practice’ and that despite GPs roundly rejecting the contract offer earlier this year ‘still nothing was done’.
Dr Bramall-Stainer said: ‘We had a huge response to this ballot, and the results are clear – GPs are at the end of their tether. This is an act of desperation.
‘For too long, we’ve been unable to provide the care we want to. We are witnessing general practice being broken. The era of the family doctor has been wiped out by recent consecutive Governments and our patients are suffering as a result.’
And she said that although the new Government ‘is keen to find solutions’ the ’causes of practices closing and GPs leaving remain’.
‘These actions will help keep practices open and keep GPs in the NHS workforce so we can buy time for Mr Streeting to make the necessary changes that were promised in the Labour Party’s election manifesto.
‘We understand that the new Government has inherited a broken NHS, and we’ve had some positive conversations with the new health secretary about the situation in general practice. The DDRB award is a small step in the right direction but we still have hundreds of millions less resource to run our practices compared to even five years ago.
‘Practices are still closing, so we have no choice but to move ahead with collective action to protect our practices, and our patients.’
According to Dr Bramall-Stainer the GP action will ‘not be a big bang’ but ‘a slow burn, with the impact likely to ‘not be felt for some time’.
‘We hope this will give the new Government time to consider our proposed solutions including fixing our contract once and for all.
‘General practice should be the front door of the NHS, not the doormat. We don’t want to have to take this next step but must if we’re to stop our services from collapsing completely. A key Labour manifesto promise was to bring back the family doctor, and we look forward to making sure that can become a reality as soon as possible.’
RCGP chair Professor Kamila Hawthorne said that the result of the ballot ‘shows the strength of feeling’ among GPs across England, as the current contract is ‘failing to provide GPs and their patients with the support that they need’.
She added: ‘It is not for the RCGP to get involved with contract negotiations between the BMA and NHS England, nor to influence whether practices participate in collective action or what form that takes.
‘But whatever actions practices take will have an impact, so we want to see an end to this action as a matter of urgency, and we urge the Government to intervene and come to a resolution that is fit for purpose for patients and the GP teams working harder and harder to provide their care.’
Responding to the ballot results, NHS England urged patients to continue to come forward for GP care ‘as usual’ during the action.
‘GP services across England will begin collective action on Thursday 1 August for an indefinite period of time, and while there may be some disruption to services practices will remain open as usual and patients can make requests by phone, online or by walking in,’ it said in a statement.
NHS England’s primary care director Dr Amanda Doyle said: ‘GPs and their teams are the bedrock of the NHS, and we recognise they are working really hard and dealing with record demand. On behalf of patients, the NHS has a duty to plan for collective action, and we will continue to work with government to find a resolution and end collective action.
‘Our message to the public remains the same – they should continue to come forward for care during this collective action, as GP practices will remain open.’
Last week, NHS England told ICBs and trusts to prepare for an impact on the whole system should GP practices decide to take collective action.
And, earlier this week, NHS leaders warned that GP collective action could have a ‘catastrophic’ impact on A&E and other NHS services.
Today, NHS Providers’ deputy chief executive Saffron Cordery said: ‘Like so much of the NHS, GPs are under unprecedented pressure. They are an essential part of our health system, helping people to stay well and a gateway to specialist care for those who need it.
‘Industrial action by GPs will hit patients hard as wider NHS services feel the knock-on effects.
‘Relentless pressure on primary care, plus many practices closing across England, means patients are turning to already busy accident and emergency (A&E) departments to seek help.
‘Today’s announcement means even more patients understandably will turn to under-strain A&Es and other highly pressurised services including 111, ambulances and mental health support.
‘First-class work done by GPs and primary care services must be valued. The Government has pledged to train thousands more GPs and to bring back the ‘family doctor’. More investment is needed to attract, keep hold of and nurture GPs and other vital primary care professionals.’
NHSE’s board heard last week that the system is ‘already starting to see tension’ as a result of practices ‘pulling back’ from doing discretionary work.
The BMA’s full list of actions GP practices are encouraged to take
- Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25. Divert patients to local urgent care settings once daily maximum capacity has been reached. We strongly advise consultations are offered face-to-face. This is better for patients and clinicians
- Stop engaging with the e-Referral Advice & Guidance pathway – unless for you it is a timely and clinically helpful process in your professional role.
- Serve notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of your business and staff.
- Stop rationing referrals, investigations, and admissions
– Refer, investigate or admit your patient for specialist care when it is clinically appropriate to do so.
– Refer via eRS for two-week wait (2WW) appointments, but outside of that write a professional referral letter in place of any locally imposed proformas or referral forms where this is preferable. It is not contractual to use a local referral form/proforma – quote our guidance and sample wording - Switch off GPConnect Update Record functionality that permits the entry of coding into the GP clinical record by third-party providers.
- Withdraw permission for data sharing agreements that exclusively use data for secondary purposes (i.e. not direct care). Read our guidance on GP data sharing and GP data controllership.
- Freeze sign-up to any new data sharing agreements or local system data sharing platforms. Read our guidance on GP data sharing and GP data controllership.
- Switch off Medicines Optimisation Software embedded by the local ICB for the purposes of system financial savings and/or rationing (rather than the clinical benefit of your patients).
- Defer signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance is available. In the meantime:
– Defer signing off ”Better digital telephony” until after October 2024: do not agree to share your call volume data metrics with NHS England.
– Defer signing off “Simpler online requests” until Spring 2025: do not agree to keep your online triage tools on throughout core practice opening hours, even when you have reached your maximum safe capacity. -
Defer making any decisions to accept local or national NHSE Pilot programmes whilst we explore opportunities with the new Government.
Source: BMA
Shame that Prof Barnfield decided it would be a good idea to come out with anti Crass report statements that appear to be driven by ideology and beliefs rather than science. As can not see myself in any shape or form associated with views like this, I had to cancel my membership with the BMA
PCNs and PCN CDs are a roadblock to a sustained improvement back to cost effective, patient focussed , practice based Primary Care.
Whilst PCN CDs continue to receive contemptuous financial incentives to improve their own self indulgent positions at the cost of colleagues and continue to have a seat at the ICB and NHSE tables , they will continue to serve their own needs at the cost of wider Primary Care and their colleagues as we have seen for years and continue to witness.
Temporary measures will not correct this underlying PCN malaise.
More dishonesty from the BMA, uncritically regurgitated by Pulse.
8,500 GP partners and contractors voted in the British Medical Association ballot to support industrial action.
There are at least 37,000 GPs in England.
This is a small MINORITY of GPs who support Industrial Action.
More dishonesty from the BMA, uncritically regurgitated by Pulse.
8,500 GP partners and contractors voted in the British Medical Association ballot to support industrial action.
There are at least 37,000 GPs in England.
This is a small MINORITY of GPs who support Industrial Action.
It is good the BMA has given us guidance and taken action. Most GPs are unhappy with the contract. We are also doing a lot of free unpaid work and attending unpaid useless meetings. Juniors and consultants got a raise so GPs deserve one too. The Barristers got 15% without even any action. Although the BMA can do better, they are at least helping us unlike the GMC and CQC.
Locums do not decide on practice matters.
It is not really very helpful of NHSE to state that patients should continue to access GP surgeries by just walking in and turning up, because workforce constraints mean that we do not have the capacity to deal with walk-ins immediately, and they may find the waiting times frrustrating if they do not book an appointment by phoning in, and unfair on those who do phone to book, where they are able to.
It would also lead to an increase in numbers waiting in waiting rooms, increasing risk of transmission of infections during the ongoing pandemic of Covid, when we are trying desperately to keep down the numbers at risk of exposure in waiting rooms ! and this also imcreases pressure on GPs to see patients rapidly and in rushed fashion to try to reduce opportunities for infection spreading in waiting rooms. This advice from NHSE is bad all round. They should encourage patients to book an appointment and undergo telephone triage where possible before attending, especially during a Pandemic where unrestricted access to GP waiting rooms increases the sickness and death and long covid rates in the population.