GPs across England could refuse to share patient data and limit the number of patients they see to 25 a day after British Medical Association (BMA) members overwhelmingly backed industrial action.
The move and potential limitations on activity could place further demands on remote GP services offered through health and protection insurers and potentially slow down underwriting for cases where medical evidence is required.
The BMA revealed this morning that more than 8,500 GPs in England took part in a ballot, with 98.3% voting in favour of taking part in one or more examples of collective action.
This means from today the BMA will encourage practices to choose from a list of 10 actions, with practices being asked to choose to implement as few or as many as they think appropriate.
These include:
- Limiting daily patient contacts per clinician to the UEMO recommended safe maximum of 25. Diverting patients to local urgent care settings once daily maximum capacity has been reached, with a strong recommendation that consultations are offered face-to-face.
- Stopping engaging with the e-Referral Advice & Guidance pathway – unless it is a timely and clinically helpful process in a GP’s professional role.
- Serving notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of practices’ business and staff.
- Stopping rationing referrals, investigations, and admissions.
- Referring, investigating or admitting patients for specialist care when it is clinically appropriate to do so.
- Referring via eRS for two-week wait (2WW) appointments, but outside of that write a professional referral letter in place of any locally imposed proformas or referral forms where this is preferable.
- Switching off GPConnect Update Record functionality that permits the entry of coding into the GP clinical record by third-party providers.
- Withdrawing permission for data sharing agreements that exclusively use data for secondary purposes (i.e. not direct care).
- Freezing sign-up to any new data sharing agreements or local system data sharing platforms.
- Switching 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 patients.
- Deferring signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance is available.
The BMA pointed out that general practices get only 6% of guaranteed funding of the entire NHS budget.
The BMA’s GPC England Committee said it believes this needs to gradually increase by 1% year on year, to 15% – all the while protecting existing funding across the wider system.
General practice is broken
Dr Katie Bramall-Stainer, chairwoman of BMA’s GP committee for England (GPCE), said: “We had a huge response to this ballot, and the results are clear – GPs are at the end of their tether.
“This is an act of desperation. For too long, we’ve been unable to provide the care we want to. We are witnessing general practice being broken. The era of the family doctor has been wiped out by recent consecutive governments and our patients are suffering as a result.
“There have been countless opportunities to address the funding crisis in general practice, and despite almost 100% of GPs voting to reject the 2024/25 contract earlier this year, still nothing was done.
“Practices are now struggling to keep the lights on, can’t afford to hire much needed GPs and other staff, and some have even closed for good.
“The new government is keen to find solutions but the causes of practices closing and GPs leaving remain, these actions will help keep practices open and keep GPs in the NHS workforce so can buy time for Mr Streeting to make the necessary changes that were promised in the Labour Party’s election manifesto.“
Bramall-Stainer said the BMA understood the new government had inherited a broken NHS, and there had been some positive conversations with the new Health Secretary about the situation in general practice.
“The DDRB award is a small a step in the right direction but we still have hundreds of millions less resource to run our practices compared to even five years ago,“ she continued.
“Practices are still closing, so we have no choice but to move ahead with collective action to protect our practices, and our patients.
“This will not be a ‘big bang’. It will be a slow burn. It’s likely that impact may not be felt for some time. We hope this will give the new government time to consider our proposed solutions including fixing our contract once and for all.
“General practice should be the front door of the NHS, not the doormat. We don’t want to have to take this next step but must if we’re to stop our services from collapsing completely.
“A key Labour manifesto promise was to bring back the family doctor, and we look forward to making sure that can become a reality as soon as possible.”