BMA demands Government halt 1 October GP contract changes

Exclusive The leader of English GPs has demanded that the Government pauses contractual changes due to come into effect next month, until ‘significant concerns’ around patient safety are addressed.

In a letter to health secretary Wes Streeting and primary care minister Stephen Kinnock, BMA GP committee England chair Dr Katie Bramall said that the changes must be deferred and reiterated the committee’s intention to re-enter dispute from 1 October, should significant concerns regarding patient safety not be ‘adequately addressed’.

However, Pulse understands that some GPC members think the letter does not go far enough and does not reflect the safeguards that the committee have previously called for.

In a message to GPs, Dr Bramall said that the GPC are ‘considering all options’, including ‘potential legal action’, to ‘ensure the most harmful aspects of this Government policy are challenged and reversed’.

‘Should Government double down, we will have no option but to ballot contractors across the country as to the potential next steps,’ she added.

From 1 October, GPs will need to keep online systems open for patient requests between 8am and 6.30pm for routine enquiries – but the BMA is arguing that because the systems can’t tell the difference between routine and urgent, serious problems could be ‘lost inside the huge haystack of unmet patient need’.

The Government said the BMA had signed up to and GPs had agreed to this policy – however several LMCs had called for the BMA to re-enter dispute over the changes. And last week the BMA announced that, following a GPC vote, English GPs will re-enter dispute with the Government.

In her letter, seen by Pulse, Dr Bramall said: ‘Online systems currently cannot distinguish between non-urgent and urgent patient queries, so the safeguards agreed within the GMS contract must include an IT solution which mitigates urgent requests being submitted via routes intended for routine appointment requests.

‘We are seeking that you defer the contractual changes until this functionality is available from online consultation providers, or work with GPC England to seek a pragmatic compromise, e.g. permitting practices to have online access each day from 08:00, until an agreed later point in the day when the online consultation element of online access is diverted to walk-in and telephone contact, in order to be able to safely manage patient need until the practice closes at 18:30.’

The letter also mentions concerns around GP Connect allowing community pharmacy to send consultation summaries into the GP practice workflow, which had already been raised by the BMA and RCGP joint IT committee, and asks the Government to also pause this requirement, due to come in from 1 October.

Pulse understands that some members of the GPC think that Dr Bramall’s request to defer the changes and to ‘seek a pragmatic compromise’ does not go far enough and does not reflect what the committee had discussed and voted on.

They also told Pulse that the letter ‘focuses on technicalities’ and does not mention the demand for practices to be able to switch off online tools when at capacity.

The GPC members also said the letter does not reflect the wording of the dispute motion (see box), which mentions ‘uncertainty and jeopardy arising from the 10-year plan’ as one of the reasons to go back into dispute.

The committee also unanimously voted in favour of a motion calling for ‘a formal review into GPC England and associated teams’ processes and workings’ which will report back to the November GPC England meeting.

It follows an internal row within the GPC on the approval of the October changes. Dr Bramall previously acknowledged the concerns and said that the amended regulations were received by the BMA from the Department of Health and Social Care in April but that they were not shared with the relevant policy group.

Pulse has approached the Department of Health and Social Care for comment.