Copperfield tears the 2025/26 GP contract a new one, asking: whatever happened to collective action?
New contract, same tropes. A smoke-and-mirrors financial offering, tick, an intriguing little bonus, tick, a sting in the tail, tick.
Specifically, in that first category, we have the increased global sum funding. But we also have the NI hike, the NLW rise, the recycling of money from QOF, the take-away-the-number-you-first-thought-of and, tadaa…er….ah.
Which inevitably forces us to look at any other potential money spinners, and leads nicely onto the ‘bonus’. That’s the £20 per pop for A&G, which does sound kerchingy. ‘More detail’ is required, of course, but the word on the street is that the fee is per interaction, not per overall episode. So I’d be starting a lot of my A&Gs with, ‘Dear consultant, do you know, I’ve completely forgotten what I was going to ask for advice on, I’ll get back to you later.’ And when I do, I’ll leave out as much detail as possible. Etc. Problem is, the A&G dosh is capped at ICB level, so I’d have burned through it by May.
Which leaves the stinger: the mandate to produce a ‘patient charter’ setting out what I should be doing for my patients and what they should do if I’m not. It’s always great to raise expectations when we’re struggling to provide the basics. At least the new requirement for increased online consultation access means the punters won’t have a problem sending in their complaints.
All rather predictable. Less so was the contractual agreement prompting the order to stand down collective action, so long as Wes agrees to a seismic revamp of the whole contract at some point in the future. Remember collective action? Stopping it actually brings it back into focus, and that focus is still very blurry. To summarise the current position as best I can: we can now go back to doing the things we shouldn’t have been doing in the first place because they weren’t contractual, but we must do them safely, as if we’re still taking collective action, but we’re not, though we did say that being non-contractual, action should be permanent, but that permanence was in retrospect temporary. OK?
Sorry this was a rather predictable blog trotting out the old ‘smoke and mirrors’ and ‘devil in the detail’ cliches, but as a blogger that’s what I’m contractually obliged to do. As for what I’m contractually obliged to do as a GP? God knows.
Dr Tony Copperfield is a GP in Essex
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Collective action should continue until new contract talks are completed – not this fudge of a contract pay adjustment with money in a t one end, and removed via NI payments and QOF recycling etc.
Meaning ful chnges, in shift in hospital funding to primary care, workload safe limits, and resolution of the recruitment crisis and stall on jobs for trainees and GPs at a bare minimum.
It doesn’t matter what they say about collective action being stopped started is is ongoing.
Now that GPs eyes have be opened to what is actually paid for in the contract, we can quite legitimately not do the things we aren’t paid for. Quite simple the status quo continues
As the BMA suffers from premature capitulation and collective dysfunction, the Govt acts quickly and expands ARRS to properly screw GPs…
And in breaking news, the Council of Lemmings votes to elect the BMA to lead its next jaunt to Beachy Head….
And finally, next week we compare the BMA to a steam train whistle – they both make a lot of noise, but is it just hot air?
Think of it along the lines of the things that used to be paid for, in QOF say, but are now just expected because the CQC say so, for free. Capped consultations were in collective action, but are now just part of how we are contracted, even though that was always the case. I’m not confused at all about whether or not to go back to doing unfunded or unsafe work, and I don’t need it to be called collective action to know I won’t be doing it!