Exclusive The BMA’s GP Committee in England is preparing for industrial action as another contract imposition looks likely, Pulse can reveal.
Last week, Pulse reported that the Government’s initial offer for the 2024/25 GP contract included a 1.9% uplift, and the GPC subsequently voted down this ‘derisory’ offer.
Committee members instructed the executive team to go back to the negotiating table with the Government and NHS England to improve the offer.
But in a letter, seen by Pulse, to Surrey and Sussex LMCs, GPC deputy chair Dr Julius Parker said it ‘is clear this may not happen’, in which case the current contract offer would be imposed for the third year in a row.
He also advised GPs to prepare for industrial action by registering with the BMA, and said the union is considering discounted membership in preparation, while the GPC will ‘provide detailed guidance’ on how independent contractors can strike.
The current Government offer also includes a reduction in QOF indicators and a move to bring nurses into the Additional Roles Reimbursement Scheme (ARRS).
Dr Parker told LMC members that the GPC’s demands were not ‘unreasonable’ and included an ask for ‘an inflation linked core contract increase’, as well as ringfencing within the contract for ‘dedicated purposes, such as GP supervisory tasks’.
However, he suggested that none of these asks were accepted by NHS England.
More details on the 2024/25 contract
The Government offer
- 1.9% increase to core funding;
- ‘Very modest’ increase in the overall ARRS allocation;
- Confirmation that GP employer NHS contributions will remain unchanged (at 14.38%) despite the employer scheme contribution rising by 3.1%;
- Suspension of a number of QOF indicators and an increase in the percentage aspiration payment;
- Further reduction in IIF indicators;
- Confirmation of the current eight service specifications within the PCN DES being aggregated within an overarching specification;
- Recruitment changes within the ARRS programme (nurses to be included);
- Changes in the arrangements for vaccination and immunisation data recording;
- Changes in the wording of the regulations in relation to patient registration arrangements, the Armed Forces Veterans offer, continuity of care and electronic records.
- Uplift by inflation the vaccination IoS fees and certain Statement of Financial Entitlement payments;
- Ringfence a proportion of current spend for dedicated purposes, such as GP supervisory tasks, or the Enhanced Health in Care Home beds premium;
- Allowing GPs with extended roles to be recruited via the ARRS;
- Inflation-linked core contract increase.
Dr Parker said the Government’s proposed changes to the contract ‘are unlikely to significantly increase’ GP workload, but this will depend on the actual wording of NHS guidance when the contract is published.
But he said that GPs need ‘significant investment’ which is ‘comparable with that seen elsewhere in the system’ if they are to deliver safe services.
He added: ‘In the medium term, General Practice needs to see a fundamental shift in the balance of financial investment across the Primary and Secondary Care sectors to properly reflect the role and workload expected of it.
‘Whilst GPC England did not necessarily expect a substantial change in the more general financial balance in 2024/25, it did expect NHS England to realise and support the principle that General Practice must receive a stabilising award in this coming financial year.
‘Without this, the risks are all too clear: practices cannot invest, reward their staff for their commitment, and meet current financial pressures, such as the planned minimum wage increase from April 2024.’
Whatever happens over the next month with negotiations, the GPC has committed to putting the Government’s offer to the profession in a referendum on 1 March.
‘Whilst GPC England have rejected the current offer, it is far more powerful to be able to convey the views
of the profession as a whole,’ Dr Parker, who is also chief executive of Surrey and Sussex LMCs, told his members.
GPC chair Dr Katie Bramall-Stainer had previously said a formal industrial action ballot may take place after April, and collective action could play out into the autumn and winter, around the time of the general election.
Dr Parker said: ‘I am aware that BMA membership is not universally popular amongst GP colleagues. Nevertheless, if the profession is to move, during this year, towards Industrial Action, albeit reluctantly given the impact on patients, this can only be organised by our Trade Union.
‘LMCs are not Trade Unions and cannot legally organise a strike. To ensure the profession can use this route, and for each GP to vote, all GP colleagues need to join the BMA.
‘GPC England have suggested the BMA organises discounted membership rates (which already exist based on income thresholds and spouse membership) to ensure this option is as widely available and as attractive as possible to all General Practitioners.’