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Independents' Day

GP leaders prepare for explosive vote on practices leaving the NHS

GP leaders will be voting on whether the BMA should support some practices to become private at the first-ever England LMCs Conference next week.

The agenda also contains a motion proposing the GPC should 'publicly dissociate itself from' NHS England’s GP Forward View unless improvements are negotiated to how funds from the £2.4bn rescue package reach practices.

Representativs from England's LMCs will gather in London next Friday, 10 November, to vote on what will become GPC England policy.

GPs in Bedfordshire have proposed the motion to have GPC England look at supporting GPs who ‘genuinely feel that they can no longer operate within the NHS’ to become privatised.

Meanwhile, several motions have described NHS England’s five-year plan for general practice as ‘woefully inadequate’ and ‘pointless’, with Kent LMC demanding that ‘the GPFV is replaced by an appropriate rescue package’.

A motion at the UK LMCs Conference in Edinburgh in May already declared that the GP Forward View is ‘failing to deliver the resources necessary’ and demanded that GPC should 'ballot GPs as to whether they would be prepared to collectively close their lists in response to this crisis’.

GPC chair Dr Richard Vautrey told Pulse last month that GPC England would be discussing the potential industrial action that would involve balloting GP practices on whether to close their lists en masse at the English LMCs Conference.

Other motions relating to the plight of workload pressures on practices include a suggestions that GPC England should discuss with NHS England the creation of a new category of list closure, which would allow practices to close their lists to patients who have not changed address.

The motion proposed by Cleveland LMC says the list closure would be done ‘in the interest of patient safety’.

Further, GPs' dissatisfaction with the work of primary care support services provider Capita is reflected in a motion suggesting NHS England should end the outsourcing contract, while a separate motion is suggesting the abolishing of NHS Property Services, with CCGs taking over practice leases.

The motion adds that GPC England should consider pushing for a guarantee that the ‘last man standing’ in a partnership should have the practice building either bought back or the remaining lease taken over by the Government.

The agenda also contains motions suggesting NHS Choices and Friends and Family Test feedback is unhelpful to practices and should be scrapped.

Motions in full

Leaving the NHS

BEDFORDSHIRE: Given that a number of GPs genuinely feel that they can no longer operate within the NHS, conference calls on GPC England to urgently look at how these GPs can be supported to operate within a private, alternative model.

GP Forward View

OXFORDSHIRE: Given the vote of no confidence in the GP Forward View at the Conference of LMCs in Edinburgh earlier this year, conference insists that GPC England negotiates improvements in the GP Forward View to ensure that money reaches practices directly without additional bureaucracy or additional workload requirements, and adequate improvements cannot be achieved within one year, GPC England must publicly dissociate itself from GP Forward View.

List closures

AGENDA COMMITTEE TO BE PROPOSED BY CLEVELAND: That conference asks GPC England to enter into discussions with NHS England:

(i) to develop a new category of list closure that would allow a practice to close its list in agreement with the commissioners, and in the interest of patient safety, so that it can, for a period, decline to accept new registrations from patients who have not changed address

(ii) to improve financial support to practices taking on patients following a list dispersal with the creation of a centrally negotiated payment per patient

(iii) to work towards funding to practices taking on patients after a list dispersal flowing in ‘real time’ and not in arrears at quarter-end,

(iv) so that commissioners must agree the terms of any list dispersal with the LMC(s) involved to ensure neighbouring practices taking on extra workload are supported appropriately and not destabilised.


AGENDA COMMITTEE TO BE PROPOSED BY BEDFORDSHIRE That conference instructs GPC England to negotiate with government:

(i) an extension to the deadline for the reimbursement package including contributions to Stamp Duty Land Tax, VAT, legal costs and service charge management fees

(ii) a guarantee that the ‘last man standing’ in a partnership will have the building either bought back or the remaining lease taken over by the government

(iii) that the lease liability for non-NHS Property Services (NHS PS) should be accepted by NHS England in the same way as for NHS PS premises

(iv) to ensure equivalent investment in partner owned premises as in purpose built and NHS Property service buildings

(v) that NHS Property Services be dissolved and the properties to be devolved to CCGs

Primary care support services


(i) make the return of the delivery of primary care support functions to the public domain a central demand in the next round of contract negotiations

(ii) urgently address Capita’s failure to correctly collect superannuation contributions in England and seek recompense for those practitioners affected

(iii) demand that NHS England prioritise PCSE service improvement with regard to financial statements so that practices can undertake informed business planning.

Source: BMA

Readers' comments (27)

  • This is not a GP vote this is an LMC vote.These folks are generally not jobbing GPs but political animals.Give us all a vote please you will get a different answer.Thought not.

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  • I'm on our LMC and we are all jobbing GPs including registrars, sessional and salaried GPs.

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  • It's a test: if the LMCs vote for leaving the NHS, then we know they are on our side; vote no, and we know they are not. Simple really.

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  • great news for Conservative HQ, Oliver Letwin etc. All going to plan.

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  • Bob Hodges

    To suggest that LMCs are not representative of working GPs suggests a deep ignorance of LMCs and what they do.

    However, like the BMA, some active LMC reps have conflated their responsibility to promote the interests of GPs and General Practices with a messianic crusade to protect the public delivered NHS at the cost of GPs.

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  • I think this is very worrying and it adds to my suspicion of the Conservative government's agenda with austerity, NHS cuts and insulting doctors, particularly GPs, on a; they appear to want to privatise the NHS. If LMCs in England vote for this the government can say it's not their fault and blame GPs (as usual). It's not good for patients either, what if they can't afford a private GP in their area? The NHS in Scotland is struggling from Westminster austerity too but there is still a positive working relationship and communication channels between GPs in Scotland and the Scottish government - workload is still heavy but in my experience there is still respect there on all sides - GPs, politicians, the Scottish media, and the general public . This makes it a pleasanter place to work. All GPs trying to work in this environment in NHS England have my sympathies.

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  • Council of Despair

    if i understand this correctly - the motion is to help those practices that want to go private i.e. it is not requiring that all practices drop the NHS. presumbly those practices that want to go private have to give up their NHS lists and responsibilities and are then free to set up as a private entity. Those patients, i guess, would then be offered NHS surgeries or could join the 'new' private practice?

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  • AlanAlmond

    We are in a total mess. In my area (West Midlands) the NHS is completely broken. Primary care is totally unsustainable in the current form. Patient demand is overwhelming. We cannot provide what the general public wants and yet (somehow) we are trying to. If the political climate is such that there isn’t the will to fund the service that is demanded what can we do? Someone from the ‘ stay in the NHS’ camp please clearly state what your plan is. If it is simply ‘carry on, keep arguing for more funding and hope things will improve’ then I’m afraid you are fools. Fools who sit by watching the destruction of some of your colleagues lives, their mental health and their futures. I put it to you that continuing with the current status quo is weak, blinkered and flys in the face of events. To keep repeating the same mistakes over and over is insanity. Come up with something solid or stop getting in the way of the inevitable. This is a truely historic time for the country and the NHS...if you can’t see this you are blind. General practice is dying. I can’t see any other solution other than to leave en-mass. Can’t you see it’s slready happening by stealth...GPs are leaving, retiring, moving abroad. WAKE UP!!!

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  • This might provide Spreadsheet Phil with a way of balancing his books!

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  • The "Save the NHS" camp plan is to continue whining endlessly and futilely for more public money, whilst bitterly opposing charges or insurance for users that might actually raise some money and put some brakes on demand.
    The NHS is doomed, please put it out of it's misery so we can move on.

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