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Independents' Day

DH urges BMA to 'consider detrimental impact' of mass GP list closures

The Department of Health has urged the BMA to consider how patients would fare if it were to put its threat of collective practice list closures into action.

The DH acknowledged that GPs 'are under more pressure than ever' but suggested last year's GP Forward View rescue deal was resolving the problem.

GP leaders told Pulse they will use their survey, revealing over half of practices are willing to close lists to new patients due to workload, to push the Government to make good on promises from the deal.

Although not a formal ballot for industrial action, the poll revealed 54% of GP practices would consider temporarily suspending registrations to ‘focus on delivering safe care to patients already on their practice list’.

A DH spokesperson said: 'GPs are under more pressure than ever, so we are backing the profession with an extra £2.4bn of funding for general practice by 2020.

'We speak regularly to the BMA about issues concerning general practice and would urge them to consider the detrimental impact which list closures could have on patient care.'

But BMA GP Committee chair Dr Richard Vautrey said the survey result showed that ‘the GP Forward View promises have not delivered sufficiently so that practices, or individual GPs, can see a tangible difference to their everyday working arrangements and the workload pressures that they are under’.

He said: 'I think the reality is that practices are putting their patients first. They are seeing the pressures that their practices are under and their first priority is their existing patients, the patients they see on a day-to-day, week-by-week basis.

'They need to provide safe care for them and this would be a step that would be part of delivering that safe care to their patients.'

He went on to outline four key areas in which the Government has to make urgent progress in order to stop practices from taking desperate measures like collectively closing lists, namely GP workforce; indemnity costs; practice workload; and premises development.

He said: ‘I think we do need to see a step change around workforce issues. We need a standard workforce, not a substitution of GPs. We need an expanding workforce as a whole.

‘We need a swift solution to the indemnity crisis because many GPs are very worried it will ultimately mean they are not able to work over winter because of the accumulative cost of indemnity.’

In addition, reflecting policy set at the BMA's Annual Representatives Meeting in June, Dr Vautrey said GPs need ‘clear ability for practices to declare workload limits so that they can protect themselves and protect their patients’.

Finally he called for ‘resolution to premises issues’, highlighting the broken Government promise of a £1bn injection in upgrades.

He said: ‘We have still not seen delivery on the promise of funding to support premise development, whether that be repair, or expansion of premises so that practices can work in a way that they need to for their patients.

‘I think it’s those areas, that the Government can deliver on, where we need to see some change.’

The news comes as the new line-up of the GPC England negotiating team are in the process of updating last year’s Urgent Prescription for General Practice, and Dr Vautrey said these demands would be the priority areas in that document.

The document will also push for CCGs to devolve funding from medicines optimisation budgets to GP practices to ensure they can hire longer-term workforce such as practice pharmacists, Dr Vautrey added.

He said: ‘Rather than having funding that’s short term and evaporates into nothing, what we need is recurrent funding so we can have a sustainable expansion of the workforce, and some of that funding is currently within CCGs.’

Asked whether these moot points would take precedent when the GPC starts annual contract negotiations, due to begin 'within days', Dr Vautrey said: 'I think we need to see what the initial response from Government is but I think ultimately this is a crisis that is self-evident and that is now being made clear by practices.

‘We do need a long-term solution that gives everybody confidence that the future will be one in which GPs and practices can play a part in sustaining the NHS and delivering good services to their patients.


Readers' comments (15)

  • Sadly it is the "criminal" actions of the DOH that are putting patients lives at risk through deliberate underfunding of General Practice.Sadly, no top individual will ever be held accountable even the "outrageous" Hunt.

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  • I wonder whether the DoH will consider the detrimental impact of its chronic underfunding of primary care which has led to this moment...

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  • why not mention pay

    9 years of pay cuts means the workforce is leaving. it may be unpopular with the public but the UK is becoming uncompetitive in attracting or retaining doctors

    lawyers, bankers and every one else exists in the market place why not use. can we merge with the RMT and get the train drivers union to negotiate? they seem to understand the point that a union is there to negotiate price for its members skills, not serve HMG or indeed the public

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  • Industrial action is supposed to have a detrimental impact!

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  • It's amazing that doctors are attacking the Department of Health and let the real culprits off the hook. A grinning Jeremy Hunt has just scored a world record, FIVE years Health Secretary. He and his sidekicks, NHS England mandarins, are paid to privatise the NHS and they are earning their money. On the other hand, we pay BMA and LMCs (is it true? Londonwide hits £5,000,000 pa?) to protect it. They have failed spectacularly. And not only we carry on maintaining them in the style they are accustomed, but we also attack the DoH for doing their job.
    There is only one way to save General Practice. Tell BMA and LMC: "Do your job properly or we stop paying you."

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  • Vinci Ho

    In a battle , one side's loss is the the other side's gain.
    It has become the common knowledge and reality that this government will definitely fail badly to reach its pledge of obtaining 5000 more GPs by 2020.
    The leaked document from home office yesterday clearly stated that even the skilled EU migrants, hence doctors and nurses ,will only be granted a permission to stay in here maximally 5 five years . Any human being with a bit of common sense GP in EU will have to think twice(even the money might be favourable to them)before taking an offer coming to UK . People need to plan for their lives , as simple as that .
    I believe when you return to negotiation on the table, the jugulars of our enemy will be exposed , Richard ....,,,,.

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  • Closing lists may have a "detrimental impact" on patients who are not yet registered with us - and to whom we have no duty of care - in order to protect the service we offer those registered patients to whom we do have a duty of care.

    Medico-legally it seems an entirely justifiable choice.

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  • National Hopeless Service

    BMA urges DH to 'consider detrimental impact' of doing sod all.

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  • Department of Health Hubris has consequences! After Hubris comes Nemesis and then Catharsis! ? Will Hunt "take responsibility " for this Chaos he has created or slide away " off the hook!"

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  • Emotional blackmail. Yeah, that'll work. Because, like, it didn't occur to GPs to think about the patients.

    I'm unimpressed that the BMA has cornered us into having to choose between saying we'll close our list, which is a form of action I would rather not take, and allowing Jeremy Hunt to stand on his dung-heap and crow that even GPs say there's no problem with our workload.

    It's just another episode in a cynical game and I don't even know what side anyone's on any more, except that GPs are very much on the side of the patients currently on our lists.

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