GPs to ‘remove or ignore’ medicines optimisation software in contract dispute escalation

The BMA’s GP committee has announced the next collective action GPs are expected take in protest against this year’s imposed contract.

From next week, the GPC is expected ask GP practices to ‘remove or ignore’ any non-contractual medicines optimisation software, and amend their choices of acute prescriptions which may fall outside the remit of the ICB formulary.

The GPC has also written to new health secretary James Murray, to request an ‘urgent’ meeting to ‘resolve the current dispute’. The letter said that if their concerns are not addressed, the GPC ‘will have no option but to introduce cumulative forms of collective action each month’.

Earlier this month, the committee said it would announce new actions to escalate the dispute, should the Government fail to provide ‘sufficient concessions’ on the imposed contract.

As part of collective action which started at the beginning of this month, GPs were told to notify their ICB that they are stopping voluntarily sharing data using a template letter provided by the union’s GP committee.

In a message to GPs, GPC deputy chair Dr David Wrigley said that the committee will ask practices to take the new action around medicines optimisation in June, ‘if this planned escalation cannot be averted’.

As revealed by Pulse, GP collective action in 2024 had already included switching off medicines optimisation software, with some ICBs estimating at the time that this specific action would cause ‘significant’ financial risks to prescribing savings.

Dr Wrigley said: ‘The next action, from 1 June, is where we ask you to remove or ignore any non-contractual medicines optimisation software, and amend your choices of acute prescriptions which may fall outside the remit of the ICB formulary.

‘For example, issuing a branded or liquid formulation may still be a perfectly acceptable and justifiable choice for the care of the patient in front of you in the consultation.

‘This action would not go so far as to breach any regulations pertaining to you or your contract. We know some of you may have this software added onto your system as part of a locally commissioned service and we will issue more guidance in the first week of June, unless action can be averted by Government.

‘Your LMC will also be able to advise further on this in due course. We are not asking you to take this action now, but will write to you again in June, if this planned escalation cannot be averted.’  

The Government previously said it remains in discussions with the GPC, as collective action will have ‘no impact’.

In the letter to the health secretary, GPC chair Dr Katie Bramall said that while ‘recent discussions’ to resolve the dispute ‘have been constructive and collaborative’, they have not yet been able to ‘agree sufficient mitigations to fully address the profession’s concerns’.

Her letter said: ‘Unless these issues are addressed, GPCE will have no option but to introduce cumulative forms of collective action each month, with our next from 1 June onwards.

‘However, there remains a clear opportunity to prevent further escalation, which would not require additional expenditure from Government and would provide a solution for the long term.

‘Specifically, this would entail amending the imposed regulations to enable the profession to move forward in good faith on negotiations for wider contract reform. Reform to restore the viability of GP partnerships, ensure fair remuneration to all GPs, and provide safeguards to keep GPs and patients safe.

‘We believe there is now an opportunity for constructive engagement under your leadership and would welcome the chance to meet with you at the earliest opportunity to discuss a way forward.’

A Department of Health and Social Care spokesperson said: ‘There have been constructive discussions with the BMA’s GPCE in recent weeks, and progress has been made. GPs play a pivotal role in the NHS, and we remain committed to working with the BMA to resolve outstanding issues and avoid escalation.

‘We expect all providers of NHS care to act in the best interests of patients, make responsible use of public funds, and work in line with established clinical guidance and local prescribing arrangements.  There will be no impact on patient services, and patients should continue to contact their GP as usual.’