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Over 40% of GP practices now limiting appointments as part of collective action

Over 40% of GP practices now limiting appointments as part of collective action

Exclusive More than four in 10 GP practices are now limiting patient appointments as part of collective action to bring about better terms and conditions, Pulse can reveal, with many more considering doing so.

This is the finding of an exclusive survey carried out by Pulse and our sister title Management in Practice, which received responses from 660 different GP practices – about one in 10 in England.

The survey also revealed that almost three quarters of England’s GPs (70%) are currently taking some form of collective action.

Only 7% said they are not planning on taking part, and 13% are currently still considering which of the BMA-recommended actions they are willing to take.

The BMA’s GP Committee for England launched the action at the start of August, with practices given the choice of which out of 10 potential forms of collective actions, including limiting patient contacts to 25-a-day per GP, declining non-contractual work, and refusing to sign new contracts with NHS England or the local ICB.

The survey showed that one of the most common actions taken by practices is limiting appointments per GP, with 41% of practices already having this measure in place, and 29% currently considering implementing it.

It also found that 42% have stopped rationing referrals, investigations and admissions, and that 27% have already served notice on any voluntary services to plug local commissioning gaps, while 31% are still considering whether to take this action.

The survey found 59% of practices have been taking action since 1 August, while 11% started earlier than that.

A GP partner who wishes to remain anonymous told Pulse that his practice in Huntingdonshire is looking to intensify its action, after having already served notice of voluntary services and stopped rationing referrals.

He said: ‘If the Government does nothing, we may intensify our action. Wes Streeting does not understand how strongly grassroots doctors feel about this.

‘We are looking to intensify our action as the Government appear not to understand our resolve on this issue.’

Warwickshire GP partner Dr Chintan Shah said that his practice has been refusing to use specific referral forms as part of collective action, to ‘reduce the burden’ of bureaucracy.  

He told Pulse: ‘We wanted to do something that would not impact patient care, but that it would have an impact on the bureaucracy – we found that every week there was a change of referral from the hospital, or sometimes it could change twice a week.

‘It takes a lot of our time to try and accommodate different specialties with their own referral templates.

‘We wanted to try and reduce the burden of burnout and exhaustion on our colleagues, which is exacerbated by other things that are not necessarily clinical – so we have been trying to push more and more work back to secondary care, and saying “no” to a lot of things.’

A GP in Essex, who also asked to remain anonymous, said that her practice has reduced the appointments available at monthly intervals by one slot off each doctor’s day.

She said: ‘Even this small change does make a difference to each GP. Our default will remain that if our patients need an urgent appointment, we will accommodate that – as we always have – even if there isn’t an empty appointment slot.’

Doctors’ Association UK GP spokesperson Dr Steve Taylor said that with so many practices taking action of some sort it shows the need for GPs ‘to be taken seriously’ when it comes to the amount of extra work that ‘they have been asked to do for no extra funding’.

He told Pulse: ‘With the current contract failing to cover costs and increase costs being brought in by the current Government in the form of National Insurance and staff costs, it is vital that the Government makes funding available now to ensure GPs can continue to provide the services they need to for patients.

‘A 20% real terms cut in £/patient funding since 2016, with an increase of 20% work has left many GP practices on the brink of collapse. This is not sustainable.’

An NHS England spokesperson said: ‘We are monitoring the impact of collective action to ensure patients continue to receive the care they need.

‘As some practices continue with collective action, it is essential they directly advise their patients of any changes which might impact the way they access care.’

A Department of Health and Social Care spokesperson said: ‘The NHS is broken, and the Secretary of State has been clear he wants to work with doctors to get it back on its feet, so it works for patients and staff.

‘We have taken tough decisions to fix the foundations so a £22bn boost for the NHS and social care could be announced at the Budget. 

‘This Government is committed to recruiting over 1,000 newly qualified GPs by cutting red tape, so patients can get the care they need, and NHS England is working to address training delays to ensure the health service has enough staff for the future.’

The survey results

How many practices are taking action? 

  • 59% of practices have been taking action since 1 August (when the BMA announced the action)
  • 11% had been taking action before 1 August
  • 7% are not taking action now but are planning to in the future
  • 13% are still considering it
  • Only 7% are not taking action and are not planning to
  • 3% said they did not know

What actions are practices taking?

Limit daily patient contacts per GP to a maximum of 25

  • 20% started this action before 1 August
  • 21% started this action on or after August 1
  • 29% are still considering whether to take this action
  • 22% are not planning on taking this action
  • 9% did not know

Stop rationing referrals, investigations and admissions

  • 16% started this action before 1 August
  • 26% started this action on or after August 1
  • 22% are still considering whether to take this action
  • 25% are not planning on taking this action
  • 12% did not know

Stopped engaging in advice and guidance

  • 4% started this action before 1 August
  • 22% started this action on or after August 1
  • 25% are still considering whether to take this action
  • 38% are not planning on taking this action
  • 12% did not know

Serve notice on any voluntary services to plug local commissioning gaps

  • 8% started this action before 1 August
  • 19% started this action on or after August 1
  • 31% are still considering whether to take this action
  • 26% are not planning on taking this action
  • 15% did not know

Source: Pulse survey

This survey was run with our sister title Management in Practice and was open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same practice, a total of 660 GP partners and practice managers from England responded to these questions. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 John Lewis voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the GP population.

 

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READERS' COMMENTS [6]

Please note, only GPs are permitted to add comments to articles

Nigel Dickson 7 November, 2024 1:01 pm

Too little, too late? And to be honest given how hard it is to get any sort of appointment with any flavour of health care professional” at GP surgeries these days will the general public notice this 40%collective action?. To be honest its pointless and it’s come at the wrong time given recent change of government, But then that’s the problem with the GP leadership. 14 years ago Annual LMC’s representative’s committee voted virtually unanimously for industrial action and the motion was passed. GPC at time took the vote under advisement and decitoded instead to work “constructively” with their Tory friends in government to get a “far better deal” working behind the scenes. Well that worked well didn’t it? BMA’s GPC are to blame for the current dire state of General Practice as a result of their back room deals during the Tory years.

Not on your Nelly 8 November, 2024 9:37 am

Too little and so far ineffective, What is next? we appear to going down the pension fiasco way when we last closed our doors for one day and it made no difference and the work was just done the following day.

So the bird flew away 8 November, 2024 11:18 am

I bet the public hasn’t even noticed this – it’ll be just the usual crap access for them and them not understanding why.
Instead of playing armchair intellectual games with the Govt, why doesn’t the BMA put our subs to good use and speak directly to the public about the existential danger to their primary care service – inadequate funding, rubbish constant targets and reforms from low IQ managers, and the dangers of corporate social AI killing off their GP….
And also organise demos, or is that beneath our posh class status?

Julie Barker 9 November, 2024 2:01 pm

I welcome he ability of PCNs to employ newly qualified GPs but this does not go nearly far enough. The Nuffield trust are clear that the significant chronic underfunding of GPs and lack in coherent workforce planning has caused this insane situation we have at this time: patients unable to get a GP appointment, GPs unable to find work, experienced GPs getting burnt out & stopping earlier than they would otherwise.
We need a funding formula that works for GPs & patient’s alike. It should reward improvement in patient outcomes, be properly weight to reflect higher workloads in deprived areas and flexible enough to incentivise patient- centred initiatives eg a GPSI frailty visiting service.

Merlin Wyltt 10 November, 2024 10:22 pm

The public haven’t noticed, the staff haven’t noticed the clinicians haven’t noticed. Do it properly or not at all.

Dave Haddock 13 November, 2024 6:39 pm

“Over 40%” Not even half.

Whatever happened to the BMA claim of “overwhelming support”?
Evaporated? Never existed?

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Pulse October survey