ICBs told to ensure practices meet contract requirements during GP collective action

ICBs should make sure that GP practices are continuing to meet contractual requirements during collective action, NHS England has said.

Yesterday, the BMA announced the results of its non-statutory ballot, which saw 98.3% of GP partners voting in favour of taking collective action from 1 August, in protest against contractual terms and funding.

GP practices will choose which action to take out of 10 options outlined by the BMA, including limiting patient contacts to 25 a day per GP; refusing to engage in advice and guidance;  and declining to sign new contracts with NHS England or the local ICB.

The BMA’s GP committee has stated that all 10 actions proposed ‘are already permissible’ and ‘will not result in contract breach’.

But in new guidance sent to ICBs yesterday, NHS England said that GP practices ‘will need to be able to assure their commissioners’ that they are ‘continuing to meet the reasonable needs of the patients’ during the action.

The document set out the proposed BMA actions and summarised contractual requirements that ‘will continue to apply to all GP practices’ throughout ‘any period of collective action’.

This follows NHSE communication last week which said commissioners may ‘need to seek assurance from participating practices that national and local contractual requirements continue to be met’.

The new guidance said: ‘NHS England is looking to help GP practices and ICBs to ensure they are clear about the National Contractual Requirements that must continue to be fulfilled.

‘All parties will need to work together to ensure patient safety is maintained throughout any period of collective action.’

NHS England said that GP practices which decide to limit daily patient contacts per clinician as part of collective action will ‘on request by the commissioner’ need to ‘provide assurance’ that patients who contact the GP practice ‘will continue to be appropriately triaged’.

It added: ‘If a GP practice opted to implement a blanket incoming call diversion, preventing patients from contacting the GP practice at any point during core hours, the GP practice would not (except potentially in most exceptional and very time limited circumstances) be meeting these requirements.

‘On request, GP practices will need to be able to assure their commissioners that the GP practice is continuing to meet the reasonable needs of the patients of the GP practice.

‘The commissioner can request evidence of how the GP practice is meeting this requirement.’

It also pointed out that there are ‘a number of national contractual requirements’ for GP practices to share data, both with NHS England and ICBs.

‘Commissioners and GP practices should ensure they are aware of these requirements as these must continue to be fulfilled during any period of collective action,’ the document added.

From the 1 October 2024, GP practices will be required to provide digital telephony data to NHS England, but as part of collective action the BMA has told practices to decline to provide the data until then.

The guidance said: ‘Although this requirement is not yet in force, NHS England is taking the opportunity to alert commissioners and GP practices to this incoming requirement as this may be a relevant factor in any decision making by GP practices during any period of collective action.’

It comes after NHS England denied claims that it tried to frustrate action take by GPs to switch off a GP Connect functionality from their systems, following instruction from the BMA.

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.