Distrust in BMA GP Committee behind negotiation overhaul, Pulse told

A breakdown of trust was behind the decision to overhaul the GP contract negotiation process, Pulse has been told by sources close to NHS England and the Department of Health and Social Care.

However, the BMA maintains its professionals have remained honest throughout negotiations.

Starting with the 2026/27 contract, the BMA’s GP Committee will be just one of a group of stakeholders to be consulted – rather than the traditional negotiation.

Now sources close to NHSE/DHSC have pointed to a letter sent to BMA GP Committee England chair Dr Katie Bramall on 6 November by NHS England national primary care director Dr Amanda Doyle and her DHSC counterpart Edward Scully to illustrate the breakdown in the relationship.

In the letter, the pair present the evidence from their side of how the 1 October contract changes came to be ‘agreed’ with GPCE, including communications from negotiations in February that said it would be up to practices to ensure any necessary safeguards against inappropriate requests were implemented.

The letter highlights the breakdown in communication between the parties, saying: ‘Presenting content not included in the final agreement in this way is misleading and disingenuous. The final letter was a product of cooperative and sincere efforts between all parties to reach an agreement. It is regrettable and unprecedented that you have used content that was not part of the final agreement in this way to re-write history.’

Reiterating the evidence presented by primary care minister Stephen Kinnock, and reported on by Pulse at the time, that same week, the letter goes on: ‘We did not receive any further feedback or correspondence from GPCE on this matter during the consultation period following that email. Such a misrepresentation of the Government’s and NHS England’s stance is inappropriate and unprofessional.

‘We hope this clarifies the matter conclusively and confirms that the contract changes effective 1 October are precisely those agreed upon by you in February and endorsed by the broader GPCE
during their vote.’

In a letter to colleagues yesterday, Dr Bramall said the decision to overhaul the GP negotiation process has ‘been considered for a long time, and is not purely a reflection of current challenges’.

However NHSE/DHSC sources, as well as numerous GPC sources, told Pulse that was not the case.

One GPCE member told Pulse: ‘It seems obvious that the current crisis is due to a breakdown of trust. The letter from NHSE of 6 November offers evidence that NHSE had clarified that the implementation of the 1 October changes would not be conditional upon the safeguards, contrary to what the profession was told at the time by GPC leaders.

‘Meanwhile, we have not been provided with any evidence from the GPC side that NHSE’s statement is false. If the GPC exec missed (another) important email then that’s a separate issue and they should own it, but it seems ridiculous to expect the profession to trust the GPC’s version of events when no supporting evidence is offered by our own side.’

A BMA spokesperson said: ‘We have remained honest throughout this process, as you would expect from a team of regulated medical professionals. The timeline of transparent correspondence can be found on the BMA’s GP campaign webpage.

‘We are at risk of losing sight of what all parties ultimately want: clinically safe environments to meet the needs of our patients. If we act in the best interests of patients and the profession, there is still ample opportunity for this government to rebuild general practice, and transform the NHS experience for the 1.5 million patients using our services every day.’

Dr Bramall previously presented her side of the argument in an op-ed for Pulse earlier this month, where she said the BMA has ‘nothing to hide’ and all communication is published on the BMA’s website.