The BMA has dropped two of its options for GP collective action, including seeing patients face to face as default.
The union is currently planning for potential GP collective action to commence on 1 August, depending on the result of a ballot of GP partners which will close on Monday 29 July.
In the ballot, partners are being asked if they are ‘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 initially included seeing patients ‘face to face as a default’, however this option no longer features.
Pulse understands that this was in response to feedback it received from LMCs during roadshows around the country, in which practices fed back that they wanted the menu of actions to be simpler.
Also removed is the option of switching off the GP Connect functionality which permits remote NHS 111 appointment booking, providing instead ‘a dedicated telephone connection for when the practice has capacity to receive calls’.
Pulse understands that this is due to the GPC awaiting further advice from its legal team.
The GPC has indicated that the menu of options will be a ‘first phase’ of action, and that ‘further escalation’ beyond a non-statutory ballot can be stopped if the Government agrees to make ‘contractual improvements’ in 2024/25 and restore GP funding to 2018/19 levels.
But ‘phase two’ could involve ‘escalation’ to contract breach actions, ‘action short of strike’ and ‘strike action’, which may include salaried GPs, registrar GPs and or other practice staff.
The current menu of actions
- 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.
- Stop engaging with the e-Referral Advice & Guidance pathway – unless it is a timely and clinically helpful process for you in your professional role.
- Stop supporting the system at the expense of your business and staff – serve notice on any voluntary services currently undertaken that plug local commissioning gaps.
- 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 where this is preferable. It is not contractual to use a local referral form/proforma – quote our guidance and sample wording - Switch off GPConnect functionality to permit the entry of coding into the GP clinical record by third-party providers.
- Withdraw permission for data sharing agreements which 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.
- Practices should defer signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance.
– Defer signing off “Better digital telephony”: do not agree yet to share your call volume data metrics with NHS England.
– Defer signing off “Simpler online requests”: do not agree yet to keep your online triage tools on throughout core practice opening hours, even when you have reached your maximum safe capacity.
-Read our guidance on this.
Source: BMA
The GPC said that it is up to practices to choose which actions to take from the menu and that these ‘may depend on your patients, local contracts and LMCs’ feedback’.
Their advice added: ‘You can choose to start slowly and build incrementally or do all of them from day one as you wish. You do not need permission to do any of these actions. They are already permissible and will not result in contract breach.’
Last weekend, GPs took urgent action to remove from their systems the GP Connect update which permits third parties to add codes to patient records – one of the options recommended in the menu of action – after the BMA was told that NHS England was planning to stop this.
At a GPC roadshow last week, GPC England chair Dr Katie Bramall-Stainer raised concerns that NHS England could use cloud-based telephony data to ‘performance manage’ GP practices and as part of collective action, the GPC is advising practices to ‘not agree yet to share call volume data metrics with NHS England’.
She also said the committee will not accept another multi-year contract deal with the Government ‘anytime now’.
The GPC’s asks of Government will be summarised in a ‘vision document’ being launched at a roadshow at BMA House on Thursday 18 July.
It follows a referendum by the GPCE which found that 99% of GPs did not agree with the recent contract imposition, as well as the committee officially declaring a ‘dispute’ with NHS England.
