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What the ballot on industrial action may mean for GPs

What is the BMA doing?

The BMA’s FAQs on the issue say it is sending out forms to be completed by practices – not individual GPs – asking them if they would be prepared to: 

i) Temporarily suspend new patient registrations; and/or

ii) Apply to the commissioner for formal list closure.

However, this is just an indicative ballot, so even if the majority of practices were in favour of such action, the BMA will not be bound to take such measures forward.

The FAQs state: ’If this ballot shows that most practices in England believe this is a course of action that should be taken then GPC (the BMA’s GP Committee) will request BMA Council to review the results and consider taking steps to conduct a formal ballot on industrial action.’  

Why is it doing this?

At the LMCs Conference in May, local leaders voted for the BMA to ballot practices on this form of industrial action.

The BMA says that the intention is ’to put pressure upon the government to deliver the resources necessary to secure the future of general practice and to enable it to provide safe patient care’.

What will this mean?

The BMA says that the first option – temporarily suspending new patient registrations or closing the practice list – means’ you will not register new patients when they approach you directly’. However, it adds, NHS England are still able to allocate patients to a practice and there is no mechanism for refusing to accept allocated patients, ’so it is likely that you would have to continue to register new patients’.

Patients would be able to contact their commissioner if they have difficulty registering with a GP, who will be able to allocate them to a practice for registration.

Will this constitute a breach of contract?

The first option – temporary suspension of new patient registrations – does risk a potential a breach of contract. However, it says ’there is no case law in this regard, which means definitive advice is difficult to offer’.

Formal list closure requires an application and approval by the commissioner. A practice that suspends new patient registrations when their application has been refused would be in breach.

However, regardless, if a patient needs GP services urgently, and an alternative service is not suitable or available, the contract requires practices to see such patients as a temporary resident or as an immediately necessary patient.