Over 40% of GP practices now limiting appointments as part of collective action

Exclusive More than four in 10 GP practices are now limiting patient appointments as part of collective action to bring about better terms and conditions, Management in Practice can reveal, with many more considering doing so.

This is the finding of an exclusive survey carried out by Management in Practice and our sister title Pulse, which received responses from 660 different GP practices – about one in 10 in England.

The survey also revealed that almost three quarters of England’s GPs (70%) are currently taking some form of collective action.

Only 7% said they are not planning on taking part, and 13% are currently still considering which of the BMA-recommended actions they are willing to take.

The BMA’s GP Committee for England launched the action at the start of August, with practices given the choice of which out of 10 potential forms of collective actions, including limiting patient contacts to 25-a-day per GP, declining non-contractual work, and refusing to sign new contracts with NHS England or the local ICB.

The survey showed that one of the most common actions taken by practices is limiting appointments per GP, with 41% of practices already having this measure in place, and 29% currently considering implementing it.

It also found that 42% have stopped rationing referrals, investigations and admissions, and that 27% have already served notice on any voluntary services to plug local commissioning gaps, while 31% are still considering whether to take this action.

The survey found 59% of practices have been taking action since 1 August, while 11% started earlier than that.

A GP partner who wishes to remain anonymous said that his practice in Huntingdonshire is looking to intensify its action, after having already served notice of voluntary services and stopped rationing referrals.

He said: ‘If the Government does nothing, we may intensify our action. Wes Streeting does not understand how strongly grassroots doctors feel about this.

‘We are looking to intensify our action as the Government appear not to understand our resolve on this issue.’

Warwickshire GP partner Dr Chintan Shah said that his practice has been refusing to use specific referral forms as part of collective action, to ‘reduce the burden’ of bureaucracy.  

He told Pulse: ‘We wanted to do something that would not impact patient care, but that it would have an impact on the bureaucracy – we found that every week there was a change of referral from the hospital, or sometimes it could change twice a week.

‘It takes a lot of our time to try and accommodate different specialties with their own referral templates.

‘We wanted to try and reduce the burden of burnout and exhaustion on our colleagues, which is exacerbated by other things that are not necessarily clinical – so we have been trying to push more and more work back to secondary care, and saying “no” to a lot of things.’

A GP in Essex, who also asked to remain anonymous, said that her practice has reduced the appointments available at monthly intervals by one slot off each doctor’s day.

She said: ‘Even this small change does make a difference to each GP. Our default will remain that if our patients need an urgent appointment, we will accommodate that – as we always have – even if there isn’t an empty appointment slot.’

Doctors’ Association UK GP spokesperson Dr Steve Taylor said that with so many practices taking action of some sort it shows the need for GPs ‘to be taken seriously’ when it comes to the amount of extra work that ‘they have been asked to do for no extra funding’.

He said: ‘With the current contract failing to cover costs and increase costs being brought in by the current Government in the form of National Insurance and staff costs, it is vital that the Government makes funding available now to ensure GPs can continue to provide the services they need to for patients.

‘A 20% real terms cut in £/patient funding since 2016, with an increase of 20% work has left many GP practices on the brink of collapse. This is not sustainable.’

An NHS England spokesperson said: ‘We are monitoring the impact of collective action to ensure patients continue to receive the care they need.

‘As some practices continue with collective action, it is essential they directly advise their patients of any changes which might impact the way they access care.’

A Department of Health and Social Care spokesperson said: ‘The NHS is broken, and the Secretary of State has been clear he wants to work with doctors to get it back on its feet, so it works for patients and staff.

‘We have taken tough decisions to fix the foundations so a £22bn boost for the NHS and social care could be announced at the Budget. 

‘This Government is committed to recruiting over 1,000 newly qualified GPs by cutting red tape, so patients can get the care they need, and NHS England is working to address training delays to ensure the health service has enough staff for the future.’

This survey was run with our sister title Pulse and was open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same practice, a total of 660 GP partners and practice managers from England responded to these questions. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the GP and practice manager population.