The BMA’s GP committee has set out a list of demands for the Government to meet in order to bring collective action to an end.
The union said today that to end the dispute the profession needs investment to ‘stop the collapse of GP practices’, as well as ‘a cast-iron commitment’ from the Government to agree and implement a new, national GP contract within this parliament.
An updated vision document published today outlined demands including for GP practice core funding in England to rise by at least £40 per patient for 2025/26, and for a new GP contract committing to a ‘minimum general practice investment standard’.
Setting out its demands, GPCE said its ‘additional ask of 11p per patient per day for essential services in 2025/26, increasing current investment from £112.50 to £152.50 per year, will stabilise GP practices and buy us time to secure a new contract fit for the future’.
It also set out a number of workforce demands, including:
- Aiming for ‘a gold standard’ of one full-time equivalent GP per 1,000 patients by 2040 alongside a safe number of 25 appointments per GP per day
- A focus on recruiting and retaining new doctors using incentive schemes and prioritising under-doctored areas
- Creating a two-year fully funded GP fellowship post-CCT practice-level scheme, part-funded from a review of ARRS budgets and productivity
- An ARRS review to potentially free up money to ringfence funding for practice-based GP nursing fellowships ‘to help practices employ more of the roles they need’
And demands concerning premises, including:
- A commitment to address the ‘crumbling’ general practice estate, ‘making it fit for the future’;
- For DHSC to allow all premises costs, including management fees, to be reimbursed – this would be ‘significantly cheaper’ and ‘would remove the inflationary risks’ from general practice, stabilising practice finances.
The document reiterated many demands made by the GPC in an earlier vision document in July which contained asks for the then-new Government, including for a 2025 Family Doctor Charter to signal a commitment from Government and NHS England to rebuild a model for England NHS general practice and bring back the family doctor.
The new document has also called for a called for a ‘substantive longer-term solution’ to embed GPs in practices beyond the 2024 emergency ARRS measures, highlighting that 80% of ‘unemployed or underutilised’ locum GPs stated they want more NHS GP work ‘but are struggling to find it’.
It mentioned that ‘despite its extremely low funding’, Professor Lord Ara Darzi’s review
on the productivity of the NHS across England ‘singled out general practice for its unprecedentedly high activity’.
It comes after health secretary Wes Streeting condemned collective action by GP last week, as he said that it is ‘in no doubt shutting the door on patients’ and that their care ‘will suffer’.
GPC England chair Dr Katie Bramall-Stainer said: ‘An extra 11p per patient, per day – that’s £40 a year for each patient – to secure more GPs, more practice nurses and more appointments would help stabilise our profession and prevent the loss of any more vital local GP surgeries.
‘Doing this would be a significant first step towards us being able to call off collective action.
‘Our document offers solutions to help the new Government deliver exactly what their election manifesto promised: to bring back the family doctor.
‘To make that a reality, we need resources put into general practice, so that surgeries can stay open and employ the doctors, nurses, and other staff they need to deliver more appointments and timely continuity of care.
‘Ultimately, we also need a commitment from the Government to negotiate a new contract in partnership with us – one that is fair and supports practices to deliver the care our patients deserve, closer to home in a local GP surgery that is well-staffed and safe.
‘The only way that can happen is by listening to the profession and working together with us to rebuild general practice in England.’
A Department of Health and Social Care spokesperson said: ‘This Government is determined to fix the front door to the NHS so everyone can get a GP appointment when they need one.
‘We have already begun hiring an extra 1,000 GPs into the NHS and put an extra £311 million funding into GP practices.
‘We are also determined to bulldoze bureaucracy and cut red tape, ensuring GPs spend less time filling in forms and more time caring for patients.’
Collective action began on 1 August after GP partners voted in favour of taking action in protest against contractual terms and funding.
After the BMA announced the results of its non-statutory ballot, which saw 98.3% of GP partners voting in favour of taking collective action, NHS England said that ICBs should make sure that practices are continuing to meet contractual requirements during the action.
As revealed by Pulse, collective actions that practices can take include declining non-contractual work, 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.
Pulse also exclusively revealed that almost half of England’s GP practices were already taking some form of collective action two weeks in, with the most popular option being limiting the number of daily patient contacts.
The health secretary previously declared that he ‘contrasts’ that with ‘some of the sabre-rattling’ seen from GPs, ‘despite’ the fact that the Government put millions of pounds ‘into GP unemployment in the first six weeks’.
Whilst the 2 Tier system of PCNs designed to destabilise practices enabled by offering carrots to the unrepresentative few and effectively bribing imo PCN CDs to continue to personally benefit to the tune of staggering tens to hundreds of thousands of pounds since the advent of PCNs despite the devastating detriment to newly qualified GPs, locums , struggling practices and in fact the ARRs they have manipulated often on poorly thought-out insecure contracts, then the current demise of General practice will persist.
Darzi centres failed once with the previous Darzi centres debacle and now he has changed track to state the obvious already known to all but with a strategy in my view to disguise any genuine concern for grassroots General Practice via controlling PCNs and PCN CDs. Who is to say his next report will not U-Turn once more and hence the NHS chaos and lack of direction will continue.
The number one aim of the GPCE should be to remove self-centred financially motivated PCN CDs followed by resistance to the continuation of PCNs which allow the government to impose restrictions and directives on General Practice led by these unrepresentative PCN CDs and the anonymous army of NHS England and ICB managers who have never been held accountable for their own catastrophic failures over decades in bringing a once effective and proud NHS to its knees.
12:02- PCN CDs are employed by PCNs. If you are in one where the CD isnt working in your interests, you need to question him/her on it and encourage change? Otherwise, vote them out?
Re GPCE. I didnt want some of these changes? going to 1k pts per GP will reduce funding. The GPCE is unrepresentative.
Spot-on from Dr Bramall-Stainer and BMA.
£40 one extra coffee a month
11p a day? In the Austin Powers movie, Dr Evil attempts to ransom the entire world with a demand of …’one million pounds’. Its a preposterous moment (because inflation has made it so little while he’s been in suspended animation). BMA must have been watching. £112 to £152 is so detached from the real world. Three haircuts a year (womens haircut £45-50)? One cup of coffee a week = unlimited care from General Practice. That’s how far this is from reality
Collective action wont end.
It is called not working beyond our contract, not doing work for nothing, and within accepted European safe limits