The majority of practices that limited the number of patients GPs could see in a day as part of collective action still have this working arrangement in place, a Management in Practice survey has found.
The survey of 496 practices in England, polling both practice managers and GPs, revealed that a total of 49% of practices capped the number of daily patient contacts at 25 under industrial action led by the BMA, which was protesting contractual terms and funding.
The BMA confirmed in February, immediately after the 2025/26 contract details were announced, that it was ‘no longer in dispute’ with the Government, meaning national collective action started last August has been paused.
Despite this, results from the survey carried out by Management in Practice and sister title Pulse, have shown that 42% of practices are still restricting daily patient contacts to 25.
And they are continuing to engage in other forms of collective action, such as refusing to take on unfunded work.
Our survey fundings showed that:
- 36% of practices are still continuing to serve notice on voluntary services undertaken to plug local commissioning gaps. A total of 11% said they had previously taken this action but stopped following the agreement of the new contract.
- 29% are continuing to ration referrals, investigations, and admissions. Another 8% said they had taken this step but have now stopped.
- 10% are still not engaging with advice and guidance. A total of 16% said they were taking this action but have stopped.
One practice manager respondent based in West Yorkshire said they were continuing to limit patient contacts because a top priority is protecting themselves from ‘burnout and overload’. Another practice manager said they had decided to limit contacts to 32, rather than the recommended 25.
In response to the survey results, BMA GP committee England deputy chair Dr David Wrigley said that new contractual changes ‘may alter how practices deliver care’, for example increasing patient access to e-consultations, but that this does not mean that GPs ‘must offer unlimited capacity that jeopardises safe patient care’.
He said: ‘While the 2025/26 GP contract agreement ended our national dispute with the Government and took us a step forward on the long road to improving general practice services in England, many practices across the country remain worryingly understaffed and under resourced.
‘With persistent commissioning gaps seeing practices not funded for a lot of the work they do, it is crucial that GP practices, working with local medical committees, are empowered to renegotiate these pathways at a local level so they are sufficiently resourced, can best serve the needs of their local patient populations and operate safely.’
In March, LMC leaders had warned that despite certain elements of the action becoming ‘less relevant’, collective action will continue, particularly around safe working and rejecting unfunded work. And limiting patient contacts per GP to 25 a day comes under the BMA’s safe-working guidance, which was updated this March.
Dr Wrigley said the BMA is urging GPs to follow safe working guidance, which has been in existence ‘for nearly a decade’.
He added: ‘To achieve safe and sustainable patient care, practices should never be forced to stretch themselves even more thinly than they already are by accepting under resourced or unfunded work.’
In some areas, collective action has led to additional funding from local ICBs. In Kent, it led to an agreement from the ICB to fund new locally-commissioned services, including for CVD and ADHD.
This survey was open between 31 March and 14 April 2025, collating responses using the SurveyMonkey tool. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 vouchers as an incentive to complete the survey. We asked for GPs’ practice codes or practice names and postcodes. We removed those with duplicate email addresses, and searched for duplicate IP addresses, removing obvious duplicate entries. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the practice manager and GP population
