LMCs consider declaring no confidence in GPC leadership over lack of dispute escalation
Exclusive A group of LMCs is considering declaring no confidence in the leadership of the BMA’s GP committee, over a lack of escalation in their dispute with the Government.
A survey of GPs in Berkshire, Buckinghamshire and Oxfordshire (BBO) found that over 77% ‘expressed dissatisfaction’ with the 2025/26 contract deal, with responses demonstrating ‘an overwhelming lack of clarity’ around the next steps surrounding the current dispute.
The respondents also expressed ‘confusion as to why no action has been taken’ since dispute over recent contract changes was declared on 1 October.
And 46.6% of respondents said they had ‘low or very low confidence’ in the leadership of GPC England to lead and represent the profession effectively.
In a message to GPs, seen by Pulse, BBO LMCs said that the results showed ‘general confusion as to the lack of strategy and direction for next steps’ in the dispute and ‘concerns around a lack of delivered results’ in the GP contract since 2024.
As a result, BBO LMCs are considering next steps, including:
- Written expressions of formal displeasure or complaint to the BMA
- Declaration of no confidence in the leadership of GPCE
- Withdrawal from engagement with the BMA and GPCE
- Withholding of part or all of the GPDF voluntary levy
The LMCs said: ‘BBO LMCs notes extensive recent press coverage of apparent difficulties within GPCE itself, manifested by questions of confidence in the leadership, and a breakdown in relationship between GPCE and Government, seemingly resulting in the sidelining of GPCE in future contract negotiations.’
They added that free text comments in the survey suggested ‘a drop off’ in communications from GPC England, with some respondents highlighting that ‘there no longer seemed to be regular explanations or briefings from GPCE on strategy and timelines for action’.
It comes after Pulse revealed that GPCE chair Dr Katie Bramall had said in December that the BMA is not going to push for GP collective action before next Spring.
The LMC said: ‘Since GPCE re-entered formal dispute with Government nearly three months ago, constituents have fed back a lack of direction from the BMA as to next steps and escalation. We also note the lack of appetite by GPCE for any imminent escalation.
‘Finally, BBO LMCs has been approached by several other LMCs regarding our level of confidence in the leadership of GPCE.
‘For the avoidance of doubt, BBOLMCs makes no comment at an organisational or corporate level in this regard without consulting constituents, as first and foremost our duty is representation, and it is for this purpose that this survey was conducted to seek the views of those we are elected to represent.’
The results in full
The survey received 148 validated individual responses from a total of 105 identifiable practices.
Respondents were asked: How satisfied are you with the negotiated 2025/26 GMS contract agreement?
They were given five options:
- Very satisfied
- Somewhat satisfied
- Indifferent when compared to prior years
- Somewhat dissatisfied
- Very dissatisfied
Just over 77% of respondents expressed dissatisfaction with the contract, with 37.2% being very dissatisfied. Just under 11% expressed satisfaction with the contract, and only one individual said they were ‘very satisfied’ with the negotiated deal.
Respondents were asked: What confidence do you currently have in the leadership of GPC England to lead and
represent the profession effectively?
They were given five options:
- Very high
- High
- Moderate
- Low
- Very low
Overall, 12.2% expressed high or very high confidence in the leadership of GPCE, with 2.7% choosing very high. In
contrast, 46.6% of respondents expressed low or very low confidence, with 15.5% saying very low. A significant proportion of respondents (41.2%) fell into the moderate band.
Respondents were asked: Which of the following statements best describes how you would rate the direct or public comms and advice from the GPC/BMA regarding the ongoing contractual dispute and next steps for action as a profession?
They were given the following statements:
- Excellent, I felt thoroughly informed and well briefed
- I understand the board direction and am awaiting further detail
- I am aware we are in dispute but not aware of a plan
- I was not aware we were in dispute
Only 2 respondents felt well briefed by the GPC/BMA, with over two thirds (67.6%) saying they had heard about the dispute but were not aware of any plan.
Source: LMC survey results shared with GPs
The BBO LMCs board will be meeting on 27 January to discuss the results and they will be deciding on how we will be taking the concerns forward.
BBO LMCs chief executive Dr Matt Mayer told Pulse: ‘BBO LMCs conducted this survey in response to concerns and questions from constituents about their contract and national representation.
‘The BBO LMCs Board will be discussing next steps at our meeting on January 27th, which will in turn need to go through our internal governance processes before any action is taken.
‘It would be premature to comment on which action(s) the Board and our Committees will take. However, our priority is to ensure value for money for our levy paying constituents.’
GPCE chair Dr Katie Bramall said: ‘GPC England policies are guided by both the committee and LMC conferences, but not exclusively, and not in isolation.
‘We do all we can to ensure our members are appropriately involved at every step. As a former chair of UK LMC conference, I take very seriously any resolution arising from conference. But the BMA has a responsibility to follow due process if a given resolution would risk contract breach or legal action to a GMS contractor.
‘We’re keen to re-energise the GPs out there so they feel ready to take on the battles both clinical and contractual that are ahead, and our schedule of webinars are starting in two weeks’ time.
‘Sadly, the committee continues to be undermined and damaged by leaks – affecting the ability to share information. We are looking forward to GPC England meeting this week, to get feedback on the detail of how we intend to engage and mobilise the profession going forward.’
Dr Bramall previously said that there were ‘no current plans’ to ballot England’s GP members in the ongoing dispute with the Government over online access changes.
At the time, LMC leaders questioned whether the suggestion that no ballot is imminent was against BMA policy, as GP leaders recently demanded ‘a clear timeline’ for a ballot of the profession, as well as backing new forms of collective action, including full-day walkouts.
The GPCE recently voted against an urgent ballot on industrial action, but in favour of calling on the Government to meet with it ‘urgently’ to discuss ‘terms of a reset in the relationship’, so that ‘further escalation can be avoided’, following a breakdown in their relationship.
As exclusively revealed by Pulse, instead of GP contract negotiations with the GPC for 2026/27, the Government will ‘consult’ it alongside a wider group of stakeholders, including the RCGP and patient groups.
Pulse has recently looked into the reasons and timeline of the breakdown in relationship between the BMA and the Government.
Read all about the GP contract fallout here
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Please note, only GPs are permitted to add comments to articles
I agree with this. the LMC conference in Manchester voted for further action and this is not being fulfilled. Hopefully other LMCs will join in and state how poor the show has been from the GPC. We can not lose to the health secretary.
In 2004 I used to read Farmer’s Weekly and noted how the s/e farmer contractors were being moved from an item-of-service/subsidy model to a global/single payment type model. Just like us GP contractors.
How our parallel paths diverged! Food security is important, but so is health security.
Farmers, despite a narrower constituency, have had the guts to visibly demonstrate by driving tractors down to Downing St to confront the Govt with their issues and get frontpage coverage. GP contractors, despite having huge public sympathy and support on our side, have failed to have the guts to even get the message across – that Govt policies are being actively designed to destroy the NHS as we know it, and hand it over piecemeal to Trump’s Big Bros America.
So pathetic, the BMA, GPC and the LMCs with their foot-dragging so-called “action” of “considering making motions”. In the current tumult with sociable (as opposed to the antisocial predatory casino capitalist) democratic values under pressure, the BMA must show leadership and organise visible action.
Constant sniping by a few disgruntled LMCs is risible and only goes to further undermine the whole profession. Regardless of personal feelings until such time as the profession appears unified we are unlikely to achieve anything …
Constant sniping or fair debate? I always believed LMC and GPCE to be a place where professionals could discuss debate and question without fear of retribution? Without fair and reasonable challenge what is the point in committee?
‘Unified’ not necessary. Not every farmer agrees or contributes to the action. Just those that choose to. But all are disgruntled. I suggest a similar approach for GPs. Not every surgery has to agree the same action or even take action. But even a proportion doing so will have massive effect. Some GPs have handled the online change. At least half haven’t. Like previous action just choosing to work to rule as surgeries wish to choose will have the desired affect because most of what we do is not in core contract or funded. Don’t even need to take risks and breach contract. Working to rule will do it. And every surgery can choose how they work to rule. Just stopping phlebotomy or all shared care, or work requested by secondary care. Any or all will have major impact. Stop chasing unity. It is the enemy of action. Recently some farmers up country have threatened blocking distribution centres. No unity, no universality of action; just adhoc
https://www.telegraph.co.uk/news/2024/12/29/farmers-plot-supermarket-blockade-in-new-year/
I wouldn’t regard feedback from 148 GPs representing 105 practices in one region as a “few disgruntled LMCs”, or “personal feelings”. Perhaps we should repeat the same survey in our respective areas.
I would certainly welcome more clarity on next steps. It feels like time is passing with no progress. I fully supported collective action last time and feel it was called off prematurely. It would have more impact if we were unified across the country but accept total unity not essential – would just carry more weight.
I believe all opinions should be listened to and respected as per BMA guidelines. Committees are for open debate and sharing of a variety of views to come to the best possible decision for the profession.
I get tired of the ask of being “ united” This ask and the people asking for it clearly understand that the actions either they or the people they are supporting are not in the interest of the profession. If the leadership acted properly, there would be no need to ask for it
The profession is unified in its ask for honesty, transparency and for the leadership to negotiate a contract which is in the interest of the partnership model
The survey of the individual GPs, as done by BBO, is not an issue of unity- it’s an outcome of a failed contract this year, a failed direction of travel from the leadership which shows no signs of improvement with this year’s contract proposals , which is as anti partnership as it gets .
Proper leadership from GPC would be more keen to actually listen to the “ disgruntled” LMCs and colleagues , rather than dismissing them as “ the problem” and blaming them and non-unity for their actions and its outcomes
The GP community stands united in its demand for honest, transparent leadership that will fight for a contract that actually preserves the partnership model. The BBO survey isn’t a sign of division; it’s a symptom of a failed contract and a strategic direction that remains stubbornly anti-partnership. Instead of blaming ‘disgruntled’ colleagues for a lack of unity, the GPC needs to take accountability for its own decisions and start listening to the frontline voices they’ve previously dismissed!
Unity is built on trust, not compliance.
The profession is clear about its requirements: we need transparent leadership and a contract that genuinely sustains the partnership model. Recent “divisive” movements, like the BBO survey, are not the cause of our problems—they are the symptoms of a failed strategic direction and a contract that undermines our core values.
If the GPC wants a unified front, they must stop labeling concerned LMCs as “the problem.” Effective leadership means:
• Prioritizing frontline feedback.
• Taking responsibility for past negotiation failures.
• Stopping the “anti-partnership” trajectory of new proposals.
Blaming the membership for a lack of unity is a deflection. It’s time to listen. We have had enough
This report reflects widespread and legitimate frustration among GPs. Dissatisfaction with the 2025/26 contract, uncertainty over strategy, and the lack of visible escalation since the dispute was declared have understandably eroded confidence in national leadership. LMCs are right to seek the views of their constituents and to consider formal mechanisms of accountability. This should be seen as a constructive call for clarity, direction, and effective representation.
BBO LMCs should be commended for undertaking this work and seeking a clear, evidence-based view from their constituents. If all LMCs did the same, we would have a far more accurate and honest picture of confidence, priorities, and appetite for action across the profession. Why is this taken differently-there is nothing “disgruntled” about this . In fact there should be national call out for something similar for all LMCs.