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GPs write to CCG to say they are stopping all 'unfunded' work

Exclusive GPs in Lincolnshire will stop offering non-essential services they not commissioned to provide unless they are given the cash to do so under a new LMC-led campaign, Pulse can reveal.

Around 100 practices in the area have drafted letters to CCGs notifying them of their intention to stop offering unfunded services, which could see them stop providing treatments such as ear care, ECGs and 24 hour blood pressure monitoring.

It comes as Dr Chaand Nagpaul identified the withdrawal of non-contractual work as a potential legal form of action that practices can take to reduce their workload in an email to practices, as Pulse exclusively revealed. 

Lincolnshire LMC's move represents the first reported example of an LMC going ahead with this organised form of action.

The LMC told Pulse it was currently in discussions with the CCGs in the county about the proposals, and hoped to resolve the issue by March 2017.

The LMC's members originally voted in favour of taking the action in February. It came in response to the Special LMCs Conference in January, which first mooted the possibility of GPs signing undated resignationsa move recently shot down by the GPC.

GPs in the region indicated they would not be willing to submit resignations, so the LMC proposed for members to stop doing unfunded work as a means of highlighting the pressure GPs were under.

Dr Kieran Sharrock, medical director of Lincolnshire LMC, told Pulse: ‘Our practices were feeling the pinch. We arranged a meeting in February to find out what sort of industrial action they wanted to take.

‘They didn’t want to strike or sign a mass resignation letter because they didn’t want to take any action which could harm patient care so they decided that they would look to stop offering non funded extra services.’

He added: ‘Staff felt that they shouldn’t be offering these services if they haven’t been commissioned to do so and wanted to ask commissioners to find alternatives. They don’t want to withdraw services but they cannot do everything.’

Dr Sharrock said that these services were already being commissioned elsewhere in the county, but that some GPs had been offering the services to benefit patients without being commissioned.

He added: ‘The ideal situation would be that the practices get commissioned to provide the services themselves because that would be better for patients. The GPC has been pushing for practices to refuse to do unfunded work. Most of the stuff which we are not being funded for should be funded – it is in other areas. These services should be standard across the country.’

Gary James, accountable officer of NHS Lincolnshire East CCG, said: ‘As CCGs we are talking with our member practices and the LMC in an effort to address practices’ concerns and find suitable solutions.

‘This may take time to work through, however, patient safety is always our first priority and we want our GPs to be able to continue to offer Lincolnshire patients a safe and high quality service.’

CGs with large deficits have been looking to cut local enhanced services offered by GPs in a bid to save cash.

Pulse found that three CCGs rated ‘inadequate’, NHS Kernow, NHS Walsall and NHS Shropshire were reviewing enhanced services in order to save extra cash this year.

Readers' comments (25)

  • Looks like 1st salvo is about to be fired. Let's see how long before other GP in different parts of country follow the path.

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  • Good on them. To be honest I find it incredible that we have ever been doing work that we were not paid to do. Time to stand up for ourselves.

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  • I believe that in our patch this sort of action will be co-ordinated through the local GP federation, i live in hope..........

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  • This has been done before. In Richmond, Surrey the GPs wrote to the CCG about specific unfounded work and a LES was offered.
    Good luck!

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  • It's time we either insist on work being properly resourced or we ensure someone else is responsible for it.
    Cut the plug off your ECG/ear syringe/spirometer until an LCS is offered.
    And check that the nurses you pay for are not doing work for the community nurses

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  • Outstanding. Encore.

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  • Our ECG is lying unused for the last 5 years, the Spiro programme got mucked up, we didn't re-invest. The Doppler is unused for 5 years too. We stopped buying b12s/depots and hep A and the like because we could not trace payments. We do continue to administer these once patient has got them on a script. However, ear syringing - now, we didn't think about that if that is indeed unfunded. But can we mobilize colleagues in Medway to take a step like that? I hope so as drastic times call for drastic measures.

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  • What is in GMS contract is actually very difficult to define. We did ask NHSE the same question but we never had a straigh answer and it seems a lot depends on if it is offered by other practices in UK as part of contract.

    Sorry to state the obvious but our contract is with NHSE, not CCG. Informing the CCG is important as they need to consider who will provide the service though.

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  • No money, no funny. Simples

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  • Finally GPs standing up for themselves a bit. Send all the palpitations and chest pain to a&e and patients needing syringing to ENT

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