The BMA’s current advice for GPs to stop advice and guidance (A&G) may be ‘dropped’ from its collective action options following the announcement of a £20 per request payment.
In a message to GPs and practices, GP Committee England chair Dr Katie Bramall-Stainer said that resourcing for A&G is ‘a positive step’ and is the ‘first example’ of the Government’s commitment to ‘shift activity and resource outside of the acutes’.
On Monday, the Government announced that GPs in England will be paid £20 for undertaking A&G as part of a new ‘elective reform plan’ that aims to bring down the 7.5 million-strong NHS waiting list.
In response, Dr Katie Bramall-Stainer said the advice to stop A&G as part of collective action was added to the BMA ‘menu’ because it is ‘unresourced workload transfer’.
However, she signalled a positive response to the Government’s announcement, saying it could be removed from the collective action options pending contract negotiations.
‘If it is successfully negotiated into the 2025/26 contract and resourced, then of course it could be dropped from the menu,’ Dr Bramall-Stainer said.
But she warned that care is needed in the ‘nuance’ of how NHS England’s proposed A&G expansion is commissioned, pointing out the difference between ‘being able to request an investigation, interpret the results, and manage our patient, and any expectation of doing that’.
The GPC England chair continued: ‘If it’s within our generalist skillset, and it will lead to much speedier consultant access – all the better. But this is not for having a go at something uncommon, complex, or risky.’
In its elective plan, NHSE said that the £20 payment per request – totalling an £80m funding pot – will come from ‘splitting the existing elective tariff’.
Dr Bramall-Stainer called for ‘clarity around what funding trusts get for advice and guidance’ as GPs ‘need a fair distribution of that resource’ in order to cover medico-legal risk, patient interaction and any complaint management.
She added: ‘But if we are paid fairly, this is exactly what we’ve been asking for and it’s a positive step. And just because some situations may not warrant this, it shouldn’t mean we refuse the opportunity to deliver and get paid for any such situation which may well be appropriate.’
And the GPCE chair pushed back on any who argue that elective reform is ‘not [their] problem’, reminding GPs that 20% of their workload is managing ‘patients deteriorating on those waiting lists’.
It is not yet clear what funding mechanism NHS England will use to distribute the £20 payment per request to GPs, but they ‘expect’ it will ‘increase uptake’, from 2.4 million total requests in 2023/24 to 4 million in the next financial year.
The BMA’s current collective action menu advises GPs to ‘stop engaging with the e-Referral Advice & Guidance (A&G) pathway’, arguing that it can ‘lead to lengthy back and forth discussions with further requests for GP actions’.
A version of this article was first published by our sister publication Pulse
