The BMA has given the Government a list of changes that must be made – ‘at a minimum’ – to the imposed 2023/24 contract to avoid a threat of industrial action by GPs.
In a letter to Steve Barclay sent this week, the GP Committee for England warned that GPs stand ‘ready to act’ if ‘positive changes’ are not seen.
Pulse understands that this could include a full closure for one day by practices across England participating in the action.
The letter, signed by acting chair Dr Kieran Sharrock said ‘the contract as it currently stands is not fit for purpose’ and that ‘to rectify this, it must include at a minimum’:
- ‘Support with practice expenses to cover minimum wage uplifts for practice staff, national insurance contribution rises, and inflationary rises in energy and medical supplies. This could be funded by enabling QOF, IIF, and ARRS underspends to be utilised by practices to cover these expenses.’
- ‘Removal of the access clause from the GMS contract. This clause is unachievable without investment in workforce and infrastructure. We support the aim of this clause in the long term, but believe that the majority of practices will not be able to achieve this at this time.’
- ‘Pausing of the pay declaration requirement which will worsen attrition of the workforce and lead to worse patient care.’
- ‘Retirement and payment protection of QOF and IIF to enable practices to focus on direct patient care.’
The letter said: ‘By using funding already allocated for general practice (QOF, IIF, ARRS funding), none of these requests comes at an additional cost to the Government.
‘Accommodating these requirements would go a long way in demonstrating to the profession, that the Government is prepared to work with us, and not against us, whilst preparing to agree a new contract for 2024 and beyond.
‘Not accommodating these requirements would further undermine the profession, who we have been engaging with, and who tell us they are ready to act if they do not see positive change.’
Dr Sharrock added: ‘I would be happy to meet at your convenience to discuss this further.’
NHS England has imposed 2024/25 contract tweaks on GPs to start next month, which includes more stipulations around access but crucially no extra funding.
But, in his letter, Dr Sharrock urged Mr Barclay to ‘reconsider’ the imposition and ‘sit back down with us to agree a contract which we can accept’.
‘At this time of unprecedented pressure across general practice, the imposition of such a contract will serve only to undermine further the confidence of the profession in the Government to adequately deliver what is needed to maintain a safe and accessible general practice, for both GPs and their patients.’
As revealed exclusively by Pulse earlier this week, the GPC is planning to get together for an emergency meeting ‘around Easter’ to discuss industrial action in response to the Government’s contract imposition.
The GP Defence Fund (GPDF), which is funded via LMC levies, has agreed to directly fund the meeting after Pulse revealed that the BMA refused to do so.
Yesterday, Cambridge LMC chief executive Dr Katie Bramall-Stainer said the GPC is ‘preparing to ballot GPs.’
In an update to practices, Dr Bramall-Stainer said: ‘Urgent action by our politicians is needed, but despite significant evidence to the contrary, the severity of the problems they have exacerbated is still not being recognised.
‘Therefore the time has come to force Government into meaningful talks, and GPCE is preparing to ballot GPs.
‘All other means of changing the Government’s minds have been exhausted. The profession needs to act in unity together now, in order to secure meaningful change. It is vital that we take action, as standing by will inevitably lead to increasing patient harm.’
It has been thought that ‘strike’ action, or something similar – with GPs withdrawing services for a day – would not be possible because GPs are not employed.
But legal experts have told Pulse that this kind of option was a possibility for GP practices.