GP collective action not paused at local level, BMA and LMCs clarify

Collective action will now be aimed at ICBs rather than the Government, with GP leaders advising practices to continue at a local level despite the new contract deal.

At the end of last week, the BMA announced that it is ‘no longer in dispute’ with the Government and has therefore ‘paused’ collective action, after agreeing to a contract deal for 2025/26 which amounts to £969m of extra funding.

But now the BMA’s GP Committee England chair Dr Katie Bramall-Stainer has said bringing an end to the dispute with the Government ‘should not get ICBs who are perpetuating these commissioning gaps off the hook’.

And LMC leaders told Pulse collective action will continue, particularly around safe working and rejecting unfunded work, despite certain elements of the action becoming ‘less relevant’.

In a video to the profession, Dr Bramall-Stainer said much of the collective action menu, which included nine actions that practices could pick from, will be ‘superseded’ if the 2025/26 contract ‘goes as planned’. 

‘So we’ll need to update it, reframe it, and consolidate it around safe working guidance principles – which have been our policy for the past decade, which is still our policy – and local contracts and commissioning gaps where your LMC is vital in galvanising collective bargaining.’

The BMA had said on Friday that it ‘will now pause collective action’ to work with the Government over the coming week to ‘secure the necessary assurances’, including a commitment by mid-March for a wholesale renegotiation of the GMS contract within this parliamentary term.

It also promised to publish updated guidance which provides the ‘necessary clarity’ for practices on if and how they should proceed with collective action. 

But Dr Bramall-Stainer’s comments indicated that collective action should continue, with the focus shifted towards ICBs rather than the Government. 

‘We’re no longer in dispute with Government, but that cannot and should not get ICBs who are perpetuating these commissioning gaps off the hook. So we shall shift our focus accordingly.’

Gateshead and South Tyneside LMC chair Dr Paul Evans recognised that some elements of collective action are ‘taking a bit more of a backseat for the time being’, but asserted that it has not been paused. 

‘I don’t think collective action has stopped, and the advice I’ve given to [GP] constituents locally is that it has not stopped,’ he told Pulse.

Dr Evans, who is also a GPCE member, said: ‘There are certain elements of collective action which are now less relevant. There are other elements, like safe working guidance, that are here for the long term, that’s not being paused.’

He also said that actions such as withdrawing from data sharing agreements or rejecting unfunded work were here to stay despite the new contract funding deal, since practices ‘are still very much in dispute with ICBs’.

Dr Evans added: ‘As an LMC chair, I’ve advised all practices basically “don’t start doing things that the ICB is not going to resource you to do”. That fight is not over. The fight we’ve had with His Majesty’s Government, now that’s over for the time being. 

‘We are going to sit down with them and look at a longer term contract, and this one is OK for this year. But at a local level, no, absolutely not. So realistically, a lot of things that are in collective action, they’re here to stay.’

Similarly, Cheshire LMC has stressed that ‘local collective action’ goes on, despite the BMA’s dispute with the Government coming to an end. 

Chief executive William Greenwood advised practices to continue capping patient contacts at 25 per GP per day, refusing all unfunded and uncommissioned work, and to ‘carefully consider’ new data sharing schemes. 

He wrote on X: ‘The “agreement” with the Government relates to the national contract dispute. At local LMC level safe working limits and rejecting all non-funded work will continue and may escalate. 

‘No going back now. What was wrong yesterday is still wrong today.’

Meanwhile, GPs in Leicestershire were told they ‘can decide which parts’ of collective action they wish to continue, and the LMC will not drop its advice to push back on unfunded work.

Dr Grant Ingrams, chief executive of Leicestershire, Leicester and Rutland LMC, said: ‘As GPs are no longer in dispute with the government, collective action will be suspended. 

‘However, no part of collective action breaches your contractual obligations, so your practice can decide which parts they wish to continue. 

‘Some parts of collective action are to do with resetting general practice. For example, we are not going to drop our advice regarding work which is unfunded or underfunded, and practices should consider continuing with limiting contacts to a safe level.’

In Nottingham, GP partner and Rebuild General Practice spokesperson Dr Carter Singh said GPs should ‘definitely take a stand’ and continue safe working practices, despite the contract deal.

He told Pulse: ‘Our dispute isn’t so much with the Government. That is for the GPC and the BMA to negotiate around the table on our behalf. What our role is, on a daily basis, is to make sure that we safeguard general practice and we do what is right for the patients, but also to protect our workforce as well.’

Dr Singh said that actions such as capping patient contacts or refusing to engage with ‘antiquated proformas’ are ‘just common sense, basic safe working principles’.

‘Whether you label them as collective action, whether you label them as industrial action, whether you label them as strike, our priority should be to try and work in the best interests of our patients, but at the same time to ensure that our GPs don’t burn out, make unsafe decisions and drive themselves into the ground as a result of unsafe working.’

A BMA spokesperson said: ‘Many of the items on the collective action menu will expire when the 2025/26 contract commences – we need new materials to support ongoing safe working guidance, and national advice to support appropriate pathways of care for patients where they are either absent or inadequately commissioned.’