England’s GP partners have voted in favour of taking part in collective action in protest against contractual terms and funding.
The non-statutory ballot, which closed on Monday (29 July), saw 98.3% of GP partners voting in favour and 1.7% voting against. In all, almost 8,500 GP partners voted – 67.7% of those eligible.
The action begins today (1 August) and GP practices can choose which of 10 actions to take from a list of potential options outlined by the BMA.
In the ballot, GP partners were asked if they were ‘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 sister title Pulse, the examples include refusing to engage in advice and guidance; limiting patient contacts to 25 a day per GP; and declining to sign new contracts with NHS England or the local ICB.
The BMA will now encourage practice teams to choose actions from the menu, in discussion with their LMC.
This morning, health secretary Wes Streeting announced the Government would temporarily add GPs to ARRS this year as an ’emergency measure’.
However, announcing the ballot result to GPs this morning, GPC England’s chair Dr Katie Bramall-Stainer said: ‘GPs in ARRS is an emergency measure, but we need the new Government to rebuild trust and listen to our sustainable solutions for getting GPs into practices as well as many other suggestions which will support their manifesto commitments.’
The ballot follows a referendum of GPs carried out by GPC England (GPCE) earlier this year, which found that 99% of GPs did not agree with the recent contract imposition. Following this, the committee officially declared a ‘dispute’ with NHS England.
On Tuesday, GPCE deplored the DDRB’s recommendation – accepted by the Government this week – of a 6% pay uplift for practice staff, GP partners and salaried GPs as insufficient.
Dr Bramall-Stainer said that there had been ‘countless opportunities to address the funding crisis in general practice’ and that despite GPs roundly rejecting the contract offer earlier this year ‘still nothing was done’.
She 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.’
And she said that although the new Government ‘is keen to find solutions’ the ’causes of practices closing and GPs leaving remain’.
‘These actions will help keep practices open and keep GPs in the NHS workforce so we can buy time for Mr Streeting to make the necessary changes that were promised in the Labour Party’s election manifesto.
‘We understand that the new Government has inherited a broken NHS, and we’ve had some positive conversations with the new health secretary about the situation in general practice. The DDRB award is a small step in the right direction but we still have hundreds of millions less resource to run our practices compared to even five years ago.
‘Practices are still closing, so we have no choice but to move ahead with collective action to protect our practices, and our patients.’
According to Dr Bramall-Stainer the GP action will ‘not be a big bang’ but ‘a slow burn, with the impact likely to ‘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.’
RCGP chair Professor Kamila Hawthorne said that the result of the ballot ‘shows the strength of feeling’ among GPs across England, as the current contract is ‘failing to provide GPs and their patients with the support that they need’.
She added: ‘It is not for the RCGP to get involved with contract negotiations between the BMA and NHS England, nor to influence whether practices participate in collective action or what form that takes.
‘But whatever actions practices take will have an impact, so we want to see an end to this action as a matter of urgency, and we urge the Government to intervene and come to a resolution that is fit for purpose for patients and the GP teams working harder and harder to provide their care.’
Responding to the ballot results, NHS England urged patients to continue to come forward for GP care ‘as usual’ during the action.
‘GP services across England will begin collective action on Thursday 1 August for an indefinite period of time, and while there may be some disruption to services practices will remain open as usual and patients can make requests by phone, online or by walking in,’ it said in a statement.
NHS England’s primary care director Dr Amanda Doyle said: ‘GPs and their teams are the bedrock of the NHS, and we recognise they are working really hard and dealing with record demand. On behalf of patients, the NHS has a duty to plan for collective action, and we will continue to work with government to find a resolution and end collective action.
‘Our message to the public remains the same – they should continue to come forward for care during this collective action, as GP practices will remain open.’
Last week, NHS England told ICBs and trusts to prepare for an impact on the whole system should GP practices decide to take collective action.
And, earlier this week, NHS leaders warned that GP collective action could have a ‘catastrophic’ impact on A&E and other NHS services.
NHSE’s board heard last week that the system is ‘already starting to see tension’ as a result of practices ‘pulling back’ from doing discretionary work.
A version of this story was first published on our sister title Pulse.
