BMA formally re-enters dispute with Government over GP access changes

The leader of English GPs has written to the health secretary to confirm the BMA has re-entered formal dispute with the Government over contractual changes coming into effect today.

GPC chair Dr Katie Bramall told Wes Streeting that the Government and NHS England ‘have had six months’ to work with the BMA ‘in good faith to prepare for this date’, but that GPs now have ‘no alternative but to enter formal dispute’.

It comes after the union had given the Government 48 hours to avoid dispute, ahead of Mr Streeting’s speech at the Labour conference yesterday.

From today, GPs are contractually required to keep online systems open for patient requests between 8am and 6.30pm for routine enquiries.

The GPC says it signed up to this policy only on the condition that ‘appropriate safeguards’ would be put in place, so that urgent requests cannot be sent online and potentially missed. Dr Bramall has now confirmed that the union’s concerns have not been addressed by the Government.

Her letter said: ‘I am writing to confirm that BMA GPC England (GPCE) has now entered into formal dispute with the Government.

‘As outlined previously, unless our concerns regarding patient safety in relation to online consultations and data access were resolved before the contract clauses came into effect on 1 October 2025, we would have no alternative but to enter formal dispute. Unfortunately, that point has now been reached.’

According to the GPCE chair, several attempts have been made to achieve necessary safeguards.

Dr Bramall wrote: ‘We have consistently offered to work with government and NHS England to, as agreed by your officials in writing from February 2025, implement necessary safeguards to avoid urgent requests being erroneously submitted online by patients.

‘We also have grave concerns regarding unlimited patient need being placed upon GP practice teams, and the refusal by you to permit the temporary diverts to allow GPs to catch up, whilst keeping telephones lines on and doors wide open.’

She also mentioned recommendations published by the Health Services Safety Investigations Body (HSSIB), the Department’s own independent patient safety body, which said that NHS England should evaluate patient safety risks associated with online consultation tools used by GPs, and found that online tools were not always accessible and easy to use and did not always allow GP practices to collect the necessary information they needed to make decisions.

The letter added: ‘The Senior Safety Investigator said general practices are facing unprecedented demand and are being asked to ensure patients also have an online option to access and receive care.

‘The future of healthcare includes technology to help deliver care, but this needs to be done with recognition of any potential risks to patient safety.

‘We could not agree more, but, unfortunately, it seems the Government is ignoring its own advice.’

The BMA has reminded practices that despite the dispute, GPs must still comply with the contractual obligations, although they will be working ‘under protest’. 

It comes as the primary care minister told Pulse that the Government will not be ‘unpicking or unravelling’ the changes, which ‘both parties signed up to’.

And yesterday the health secretary accused GP leaders of ‘conservatism’, saying that their dispute over access changes risks to ‘turn the NHS into a museum of 20^th century healthcare’.