BMA to oppose Government replacing GMS negotiations with 'informal processes'

BMA leaders will debate opposing any attempts from the Government to replace formal GMS negotiations with ‘informal’ non-biding processes, including consultations and engagement exercises.

The agenda for the union’s annual representative meeting (ARM), which will take place next month, also included a motion asking all branches of practice to oppose mandated advice and guidance (A&G).

The motion on GMS negotiations condemned ‘attempts’ by NHS England and the Department of Health and Social Care to replace formal national negotiations on the GMS contract with ‘informal “consultations”, “engagement exercises”, “scoping”, or similar non-binding processes’.

It also called on the BMA to ‘robustly oppose’ such practices and to reiterate that consultations or scoping exercises ‘cannot replace legally recognised national negotiations under the GMS contractual framework’.

It comes after, as revealed by Pulse, the Government consulted a group of stakeholders on the contract changes for the current financial year – effectively ending the BMA’s role as sole negotiator of contract terms.

The ARM motion said that the BMA should prepare ‘appropriate dispute-escalation measures to protect the integrity of the GMS contract’.

It said: ‘This meeting asserts that substantive changes to the GMS contract, including funding, workload, premises, or regulatory requirements, must occur only through formal national negotiations with the BMA as the recognised representative body for GPs; [it] rejects any efforts to bypass, dilute, or re-label contract negotiations in a manner that weakens the profession’s collective bargaining or imposes changes without agreement.’

BMA leaders will also vote on blocking mandatory A&G, with a motion noting that GPs have a right to refer patients to specialists and that removing that pathway will lead to increased workload for GPs, as well as ‘uncertainty over medicolegal responsibility if a referral is rejected and clinical harm ensues’.

It demanded that the BMA continues to work with relevant bodies to develop systems through which GPs and consultants can communicate, and argued for the queries and answers between the two parties to be automatically included in medical records at both ends.

Since April, practices have been contractually required to use A&G across specialities ‘prior to or in place of a planned care referral where clinically appropriate’, but the BMA’s GP committee said it is getting legal advice on this amid fears that the requirement could remove GPs’ right to refer.

Workforce issues will also feature at the ARM, with a motion mandating the union to campaign for an expansion of substantive post CCT jobs in line with the expansion of specialty training posts; as ensuring that GP contractors can link into NHS/HSC NI childcare provision, recognising that this supports retention of the medical workforce.

Other subjects to be debated at the meeting taking place in Brighton on 22-24 June include:

Campaigning for reform of the GP partnership model to ensure it remains viable and attractive to the next generation of GPs
Calling on any assisted dying service to be commissioned as a separate service and not part of core general practice
Lobbying for legislative change to allow flexibility in the Medical Examiner process, which since its introduction has ‘created unnecessary delays for doctors to issue the Medical Certificate of Cause of Death (MCCD) with respect to expected deaths.

At last year’s ARM, doctor leaders backed a proposal to prioritise UK medical school graduates over international medical graduates (IMGs) for training posts.

The motions in full

Motion by SOUTH CENTRAL REGIONAL COUNCIL: That this meeting notes with dismay the move towards compulsory requests for advice before, or instead of, referral that was signalled in the recently imposed GP contract variations (2026- 27). This removes a GP’s right to refer and a patient’s ability to have a specialist opinion. It will lead to transfer of work from consultants to GPs and uncertainty over medicolegal responsibility if a referral is rejected and clinical harm ensues. Consultants will spend increased amounts of time triaging and rejecting patients rather than seeing them. We ask this meeting to:- i) reaffirm GPs’ right to refer their patients to specialists; ii) reject the concept of obligatory pre-referral advice, and call on all branches of practice to work together to block its imposition; iii) recognise that the doctor who has consulted with the patient is likely to have a clearer idea of when specialist input may be necessary that someone making a decision based on a letter or referral form; iv) work with relevant bodies to continue to develop user-friendly systems through which GPs and consultants can communicate when advice is wanted. Queries sent and answers received must be automatically included in the
medical record at both ends.

Motion by LOTHIAN DIVISION: That this meeting recognises the role of childcare access in retaining the medical workforce. This meeting calls on the BMA to:- i) campaign for NHS/HSC NI linked childcare provision, including on site, near site, and extended hours models; ii) ensure GP contractors and primary care services can link into NHS/HSC NI childcare provision regardless of commissioning arrangements, including
through ICBs, HSCPs or successor bodies.

Motion by BIRMINGHAM DIVISION: That this meeting recognises the GP partnership model remains central to delivering continuity of care, local accountability, and sustainable primary care services, but is increasingly under pressure due to workforce, structural, and systemic challenges. It calls on the
BMA to:- i) campaign for meaningful reform of the GP partnership model to ensure it
remains viable, attractive and sustainable for future generations of GPs; ii) work with NHS bodies and other stakeholders to strengthen support succession planning and long-term investment in partnership-led general
practice.

Motion by THE AGENDA COMMITTEE (TO BE PROPOSED BY EAST OF ENGLAND REGIONAL COUNCIL): For national branch of practice negotiations across the UK this meeting:- i) condemns any move to replace formal national negotiations with nonbinding “consultations”, “engagement exercises”, “scoping”, or similar processes; ii) calls on the BMA to oppose such practices robustly and to insist that all
substantive changes to pay, terms, conditions, training, or workforce policy must be pursued through formal negotiation frameworks; iii) mandates the BMA to escalate, including up to dispute processes where
necessary, if employers or government bodies persist in substituting consultations or scoping exercises for genuine negotiation iv) asserts that substantive changes to GMS contracts, including funding, workload, premises, or regulatory requirements, must occur only through formal national negotiations with the BMA as the recognised representative body for GPs.

Motion by EAST OF ENGLAND REGIONAL COUNCIL: Regarding negotiations of the GMS Contract in England this meeting:- i) condemns attempts by NHS England, the Department of Health and Social Care, to replace formal national negotiations on the GMS contract with informal “consultations”, “engagement exercises”, “scoping”, or similar non-binding processes; ii) asserts that substantive changes to the GMS contract, including funding, workload, premises, or regulatory requirements, must occur only through formal national negotiations with the BMA as the recognised representative body for GPs; iii) rejects any efforts to bypass, dilute, or re-label contract negotiations in a manner that weakens the profession’s collective bargaining or imposes changes without agreement; iv) calls on the BMA to robustly oppose such practices and to reiterate that consultations or scoping exercises cannot replace legally recognised national negotiations under the GMS contractual framework; genuine negotiation with non-binding processes, the BMA prepares appropriate dispute-escalation measures to protect the integrity of the GMS contract.

Motion by THE AGENDA COMMITTEE (TO BE PROPOSED BY EAST MIDLANDS REGIONAL COUNCIL): That this meeting believes that expansion of specialty training posts must be accompanied by similar expansion of substantive post CCT jobs and therefore mandates the BMA to demand:- i) that every training number is hypothecated upon a substantive post-CCT consultant or GP job upon completion of training; ii) appropriate expansion of posts to enable CCT holders in the UK to enter
employment.

Motion by NORTH WEST REGIONAL COUNCIL: That this meeting believes the introduction of the Medical Examiner service in England and Wales has created unnecessary delays in the ability for doctors to issue the Medical Certificate of Cause of Death (MCCD) with respect to expected deaths, when an urgent MCCD issue is required for religious purposes outside the working hours of the Medical Examiner office. We call on the BMA to lobby for legislative change to allow flexibility in the Medical Examiner process to allow for expedited issuing of the MCCD by a doctor, such as an out of hours GP or on call hospital doctor, in expected deaths where urgent certification is required for religious purposes, where no doctor who has ‘attended to the deceased within their lifetime’ is available, and no Medical Examiner service is available.