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GPs go forth

What GPs need to know about submitting undated resignations

Dr James Murphy clarifies what the LMCs conference motion means for you and your colleagues

At the special LMCs conference on 30 January, delegates voted for the GPC to canvass GPs on their willingness to submit undated resignations unless the Government delivers a ‘rescue package’ for general practice within six months. But what does this actually involve for you? 

What is an undated resignation?

An undated letter of resignation means what it says - a GP giving notice of intention to cease providing primary medical services to a given population, but not determining the date when this action will be initiated.

The resignations are undated because it allows the GPC to date all resignations for the same date and enables them to be submitted simultaneously to NHS England.

What would trigger undated resignations?

The GPC is seeking contract negotiations at the moment. If an adequate new GP contract is not negotiated within the next six months then the profession would start a formal process to canvass GPs on their willingness to tender undated resignations. If successful, a move to mass resignation would follow shortly afterwards.

What if not every GP in the practice submits an undated resignation?

If only a small proportion of GPs at a particular practice submit their resignations then the remaining partners would remain responsible for ensuring the continued running of the practice, as per the partnership’s contractual obligations. However some practices will have clauses in their partnership contracts which say that if a certain number of GPs resign within a certain time period then the remaining partners will also submit their resignations to enable the handing back of the contract. Therefore, this has more impact if all partners in a practice resign together.

Why would the GPC want to use this strategy?

This is preferable to other methods of campaigning, as it is extremely difficult for independent contractors to undertake industrial action without falling foul of legislation. Similarly these GPs cannot technically strike as they will be found in breach of their contracts and are not protected by employment law. Salaried GPs could strike but only if they have a dispute with their employers (usually other GPs).

If the GPC cannot get the Government to urgently recognise the serious state of general practice, undated resignations give the negotiators backing to discuss with the profession whether they are prepared to consider resignation as the only option left.

Have undated resignations been used before?

Collective use of undated resignations was used successfully in 1966 to bring about a new contract, at a time when GPs found themselves in a similar position to today with unmanageable workloads, dwindling workforce and few resources.

In 1966 those resignations were never submitted. The mere threat was sufficient to force change. While not guaranteed, one would hope we could achieve the same outcome.

What are the risks and drawbacks of GPs preparing unsigned resignation letters?

Clearly this is a ‘nuclear option’. It places the resigning GP’s career at immediate risk with all the financial ramifications that come with closing a practice, such as making redundancy payments to staff.

If the Government did allow multiple practices to close simultaneously there would be chaos for those communities affected.

However, whether or not GPs agree to this strategy, many practices are at risk of closing anyway due to their decreasing financial viability, failure to retain and/or recruit doctors, and overwhelming workload.

Will this action need a minimum engagement?

That’s for the GPC to decide. But my instinct is that there would be no need for a majority of GPs to undertake this for it to be effective.

Even a small number of practice closures could have an effect. If 20 practices scattered across England closed, NHS England could probably cope with that. But if 20 practices with 15,000 patients closed, that might be a different matter. If those 20 practices were all in a small area of the country, say all within South Buckinghamshire, this would probably be sufficient to result in the complete collapse of the health service in that area.

How should I broach the possibility of preparing unsigned resignations with partner colleagues, and non-partner colleagues?

Ask colleagues if they can manage the stresses of general practice today, ask if they are prepared for the exponential rise in patient demand predicted over the next decade, ask how they would manage if the practice next door closes and they are expected to pick up the care of displaced patients, ask if they have any faith in the Government’s current strategy for sustaining services over the next decade.

Then ask them to consider the rationale of threatened mass resignation as a way of forcing the Government to take immediate and drastic action to avert the major crisis ahead.

Dr James Murphy is a GP in Buckinghamshire who proposed the motion for undated resignations at the LMCs conference

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Readers' comments (6)

  • Interesting article.

    What about us GPs in the devolved nations? Scottish GPs are awaiting details on the new contract or April 2017.

    Need more clarity in the ballpark figures for redundancy payments.

    Also how many salaried GPs are there that will not have the chance to hand in undated resignations compared with GP partners that do have this option.

    It certainly is the time for the nuclear option to save General Practice as we know it.

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  • James and the speakers on this subject at the conference were passionate and proportional. The idea of more work and no more funding to get help is now making me anxious about the future. We are at the point were we aren't safe. I open 65+ sets of notes everyday to take an action, this is without all the letter and results where I do not need the patients notes open, how many chances are there for me to err. I do not want to be seen by a tired stressed GP if I am unwell. Ask the question of your partners, do you want to see me or any of us at the end of a working week?

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  • We have to resign from this Contract. The dentists did.
    It is wrong, whichever, whatever way you look.
    Colleagues are seeing 40+ patients, working 12 hours a day and still going under.
    Just wrong, morally, financially,socially.
    I saw a solicitor the other day. 40 pound to sign and stamp an attested photocopy. 5 copies. 200 pounds for 3 minutes work.
    We must resign. We can continue to work in the same surgery if you own it.
    You just have to charge.
    A different system, but this system is long dead. there are practices needing help everyday.
    Just wrong!

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  • interesting - it means only a few practices are needed to force badly needed change. so those practices under threat of closure or struggling may have little to lose by submitting undated resignations. If only 10% of practices (circa 800) did this - I wonder what the outcome would be?

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  • If 'twere done, 'were best done quickly. Mr Hunt right now will be sending round to the big private firms getting them to make plans to assume the practices on emergency contracts as soon as the resignations are handed in. He'll be sending a recruitment mission round Europe for strike breaking GPs there to get their English up to scratch and put themselves on a reserve list. Alick Munro

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  • I agree with Dr Munro's comments. However, I think Mr Hunt has already made these arrangements prior to imposing the contract. Ultimately it will be a war of nerves and hopefully, good luck for junior doctors and GPs.

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