Northern Ireland GPs vote in favour of ‘unprecedented’ collective action
GPs in Northern Ireland have voted in favour of taking collective action, following this year’s first-ever contract imposition.
The BMA said that 98.7% of those who took part in a referendum voted ‘yes’ to collective action that will see GP practices across the country take the ‘unprecedented’ step of withdrawing some unfunded and non-contractual services which take up ‘a significant amount of time away from patient care’.
Some of the actions which practices will take as part of this include limiting patient consultations and serving notice on any voluntary work.
It comes after the country’s health minister imposed the GMS contract for 2025/26 on GP practices for the first time, despite the offer being overwhelmingly rejected by the profession.
BMA Northern Ireland GP committee chair Dr Frances O’Hagan said: ‘This is the first time the GMS contract has been imposed on the GP workforce in Northern Ireland.
‘Therefore, it should come as no surprise that GP partners have voted overwhelmingly in favour of taking the unprecedented step of collective action to force improvements to the 2025/2026 contract offer and save general practice from all-out collapse.
‘We have been warning for well over a decade now that general practice was not being funded to meet the needs of growing patient lists and that failure to act on this would have consequences on patient care.’
NI GPC and LMC representatives developed a list of collective action measures (see box), and each practice and LMC area will be able to determine what works for them, the BMA said.
The collective action measures
1. Limit daily patient consultations
Limit daily patient consultations per clinician to the UEMO recommended safe maximum of 25, as per BMA safe working guidance. If demand for urgent care exceeds safe levels, you may wish to consider directing patients to appropriate alternative settings such as urgent care centres, Phone First, GP out-of-hours, Accident and Emergency, and the Northern Ireland Ambulance service.
2. Serve notice on any voluntary activity
The focus of this action is to cease any activity that is voluntary, unfunded and non-contractual.
Examples of such activity includes non-emergency ambulance ordering (for example for first outpatient attendance) and the ordering of pre-procedural medications or medications used for hospital tests.
Action could also include serving notice on provision of complex wound and ulcer dressings, where this best undertaken by specialists. There may be other activities that fall outside of GMS contractual obligations but have regularly been provided in general practice to prop up the wider health service. These will be considered further, and information will be provided in the detailed guidance.
3. Cease completion of unfunded paperwork
GPs currently complete large volumes of paperwork which they are not contracted to provide and which they receive no additional funding for.
Examples of action that may be taken includes ceasing to complete paperwork associated with patient registration including dealing with patient eligibility for NHS Services. Practice staff are at times expected to follow up with patients to check documents that BSO require for registration. This is not the role or the responsibility of the practice.
Action could also include ceasing to complete letters to support for issues such as:
- patient applications for social housing
- educational provision in schools
- applications to the Home Office
- reports for benefits applications
4. Switch off Medicines Optimisation Software
Medicines optimisation software often produces nuisance pop-ups on the screen during patient consultations. These pop-up suggestions may not always be in the patient’s best interest as they are used for financial purposes.
Source: BMA NI
The BMA said: ‘The collective actions measure have been assessed and evaluated by our legal team in BMA and we are confident that nothing breaches your contract, your professional obligations or any other regulations and statutory functions that you are obligated to observe.’
The Department of Health told Pulse that health minister Mike Nesbitt ‘remains open to discussion’ on the future of general practice, and that it has written to NIGPC inviting them to engage in ‘formal negotiations’ to develop a new GMS contract.
A spokesperson told Pulse: ‘The Department notes the outcome of the ballot of GP Partners by the BMA NI in relation to collective action.
‘At this time, we have not yet received formal confirmation from the BMA of the outcome, nor of the specific measures that will comprise the collective action.
‘It will be important that GPs continue to adhere to the terms of their contract while taking any action, that there is no negative impact on patient safety and that access to service are maintained.
‘The financial challenges facing the Department of Health are well-known. In that context, the £9.5m in additional funding included in the 2025/26 GMS contract represented the best possible offer the Department could make for 2025/26.
‘It is a matter of regret that the Department has not been able to reach agreement in relation to the 2025/26 GMS contract.’
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READERS' COMMENTS [2]
Please note, only GPs are permitted to add comments to articles
Does this collective action mean that GPs will still be held responsible if a patient calls the practice, doesn’t get an appointment, and then becomes abusive or threatening? It seems ministers would be delighted—they’ve effectively washed their hands of responsibility by offloading risk onto GPs while refusing to fund or support the service properly. Once again, the system sets GPs up to be the scapegoats when things go wrong, while politicians sidestep accountability.
In other countries safeguarding are done exclusively by social workers and not doctors. 10min does not qualify us to know the patient sufficiently plus this is not medicine.