GPC leaders accused of ‘misleading’ GPs as DHSC produces ‘evidence’ contract was agreed

Exclusive The BMA’s GP committee England executive has been accused of ‘misleading’ the profession and keeping colleagues ‘in the dark’ during contract negotiations – after the Government produced evidence the October changes were ‘agreed’.

Last week, the Department of Health and Social Care shared evidence with Pulse that the GPC executive had been informed in writing – before agreeing to the contract – that the changes around online access would come into effect on 1 October without software safeguards, and that it would be up to practices to put safeguards in place.

According to communication shared by DHSC, an email sent by Government negotiators to the GPC executive on 24 February – days before the GPC agreed to the final contract – said the online access requirements would ‘not be contingent on any specific software solution being found’.

But a large number of GPC members have now told Pulse this information was not shared with the wider committee in February before they voted to agree to the contract.

GPC leaders have maintained throughout that the 1 October contract changes were contingent on safeguards being put in place including software upgrades.

But in a recent letter to GPC England chair Dr Katie Bramall sent 6 November, primary care minister Stephen Kinnock said that the ‘final correspondence’ on the issue, ahead of the GPCE vote ‘on the final package’, stated: ‘The implementation of the proposal would not be contingent on any specific software solution being found. Practices will be welcome to use disclaimers on their website as they see fit.’

Mr Kinnock added: ‘We did not receive any response or further communication from GPCE on this issue during the consultation following that correspondence.

‘We trust this provides the absolute clarity you request and that you are now clear that the 1 October contract changes are exactly as agreed by you in February and supported by the wider GPCE at their vote.’

The BMA’s official position on the issue was that it had only agreed to the changes subject to the ‘appropriate safeguards’ being in place ahead of the implementation, to prevent urgent requests being erroneously submitted via the online tools, and is currently in dispute with the Government over this.

Now a large number of GPC members, who are not on the executive team, have told Pulse they never saw the 24 February email and said they were asked to vote on the contract offer without knowing the full extent of what was being discussed.

Several of the GPs told Pulse that in light of this evidence they feel the GPC executive has ‘misled’ the wider GPC and LMCs.

One GP said that the committee only found out ‘very recently’ that DHSC has been saying since February that the ‘necessary safeguards’ would only amount to practices discouraging patients from using online consultation for urgent issues, and would never extend to software changes.

‘The committee was told the opposite by the GPCE executive during the discussions about whether to accept the contract or not,’ they added.

Another GPC member said that practices ‘don’t know what to believe’ because the narrative coming from national leaders ‘doesn’t seem backed up by any evidence’ and it looks like the GPC executive ‘made a mistake and are trying to cover it up’.

Others also said that the GPC is ‘dysfunctional and not fit for purpose’ with the exec keeping members ‘in the dark’ during the negotiations.

‘This was not brought to any GPC meeting at all, the committee has been kept in the dark and then was asked to make a decision, without proper scrutiny,’ another GP said.  

One GPC member told Pulse: ‘There are several significant questions which need to be answered. If the chair of GPCE was aware of this in February, and GPCE accepted the terms of the contract in their meeting, were the committee aware of the facts that safeguards would not be forthcoming? If they were not, why not?

‘Was the contract agreed in the presence of all the facts, or were these concealed from the committee?

‘Ultimately, I’m furious. I feel misled and having spoken to my LMC constituents they feel immensely let down by GPCE.’

Another GPC member said: ‘This is very concerning because we are seeing evidence which contradicts the narrative coming from our national leaders. This is more than simple spin: the story is inconsistent. This means we have no idea what to advise practices because we simply don’t know what is true.

‘It is becoming more and more apparent that GPCE agreed a deal without realising the implications, and are now trying to rewrite events to save face and avoid embarrassment. I don’t think that is what the profession expects or deserves from its national leaders.’

Pulse gave the BMA nearly a week to comment on the evidence produced by Mr Kinnock, and more than 24 hours to respond to allegations that the executive misled the profession but the press office did not provide a comment ahead of publication.

Following publication it sent a comment from Dr Bramall, but did not address the allegations against the executive team.

Dr Bramall said: ‘At the start of this year, the Government promised GPs across the country that they would work with us to implement the necessary safeguards for online consultations that would enable practices to operate safely and prevent patient harm.

‘However, no acceptable safeguards have been introduced, and practices across the country are now struggling to safely manage with the barrage of requests coming in. This means practices are extending staff hours and spending less time with patients to make space to review online written requests, which, ultimately, leads to even longer waits for patients and delays to care that risks them coming to harm. 

‘The 8am appointment scramble hasn’t been resolved; it’s just been delayed to later in the day. On top of that, it now includes hundreds more online queries for each practice to work out what may or may not be urgent as every single request needs to be checked on the day it is received.

‘GPs spending more time doing admin than spending face-to-face time with their patients is not the success the Government thinks it is. GPs are overworked, practices are at capacity and some patients will now be waiting even longer to see their GP.

‘The Government is risking significant patient harm occurring due to this unsafe system.. The Government must stick to its promises – let us not forget the importance of working with the JGPITC (Joint GP IT committee) around GP connect update record, and most of all – the absence of any confirmation of GP practice contract renewal and investment.

‘Instead of ensuring that the necessary safeguards are implemented to guarantee the safety of patients and staff, the Government has opted to introduce unfamiliar contract mechanisms in their ten-year plan. As things stand, current capacity cannot meet demand safely.’

Last week Mr Kinnock accused BMA leaders of turning the organisation ‘into a farce’, after the England LMCs conference saw GP leaders voting in favour of escalating the dispute.