England GPs could re-enter dispute with the Government over 10-year plan

Exclusive GPs in England may go back into dispute with Government amid concerns about its 10-year health plan, Pulse can reveal.

A motion for debate at today’s meeting of the BMA’s GP Committee raises concerns about the lack of progress on a new GMS contract, and the content of the 10-year plan.

It proposes the GPC should enter into dispute with the Government ‘with immediate effect’, with options for actions to be explored in the ‘next couple of months’.

The GPC’s dispute with the Government over pay and conditions ended in March, following a written commitment from the Government to negotiate a wholesale new GMS contract within this Parliament.

However, the motion says there has not been ‘any meaningful progress’ from the Government to deliver the promise and, in addition, the NHS 10-year plan ‘poses an existential threat’ to the independent contractor model of general practice.

It warned that the plan will ‘force’ loss of individual GP surgeries and bring about the ‘death of the trusted “family doctor” model of care’, representing ‘an unapologetic broken manifesto promise by this Government’.

It also said that as part of new collective action, the GPC could advise practices to enact the outcomes from the 2025 special conference to ‘safeguard the GMS contract’.

The special LMC conference took place in March, behind closed doors, but included motions proposing escalation of collective action, including coordinated GP practice closures for an agreed period of time.

Following the conference, GPs were asked to continue to refuse unresourced work from local commissioners.

It comes after the committee’s chair Dr Katie Bramall said that general practice will not ‘be quiet’ should Government promises around a new wholesale GMS contract be broken.

Following the plan’s publication, the BMA raised concerns that it could ‘seriously undermine’ the current GP practice model, revealing that its GP committee had not been allowed to see the plan ahead of publication.

Dr Bramall added that questions about the plan will be put to primary care minister Stephen Kinnock as he will attend the GPC England meeting today.

Another motion which will be voted on today said that GPC England ‘notes the visit’ from Mr Kinnock, but still has ‘profound concerns’ regarding the ‘inherent threats’ within the plan.

It calls on GPC England to design and deliver a patient-facing information campaign warning of the risks of the proposed changes outlined in the plan.

The GPC should also ‘immediately’ write to Mr Kinnock, informing him ‘what is required’ to avoid facing a return to dispute.

Pulse has recently looked at what the 10-year plan will mean for the GP partnership model.

And the BMA previously raised concerns about plans to transfer some ICB functions to neighbourhood teams, saying that these pose an ‘existential threat’ to GPs as independent contractors.

Read all of Pulse’s coverage of the 10-year plan here.

The motions in full

That this committee, in the absence of any meaningful progress by the Secretary of State toward his promise to deliver a new core GMS contract to replace the current chronically underfunded GMS contract, believes that the Government’s “10 Year Plan” for the NHS poses an existential threat to the independent contractor model of General Practice, and:

i. Instructs GPCE officers to develop a list of non negotiable demands which should include at least £50 per patient extra per year into core GMS to “restore the core”

ii. Warns that this plan will force loss of individual GP surgeries and bring about the death of the trusted “family doctor” model of care, representing an unapologetic broken manifesto promise by this government

iii. Believes that the plan’s focus on horizontal and vertical integration at scale will result in either greater control by large private sector corporate providers; or by hospital trusts with no evidence of effective General Practice service provision

iv. Instructs GPCE officers to lead the profession in complete disengagement with the 10Year Plan to block the Integrated Neighbourhood Model with immediate effect.

v. Resolves GPCE to enter into dispute with the government with immediate effect, with the officers exploring options to enact in next couple of months, including enacting the outcomes from the 2025 Special Conference to safeguard the GMS contract

That GPC England notes the visit from the Minister for Care, but still has profound concerns regarding the inherent threats within the Government’s 10 Year Health Plan to the independent contractor model of general practice, and:

i. calls for GPC England to design and deliver a patient-facing information campaign warning of the risks posed by vertical integration and integrated health organisations, where foundation trusts may hold a registered list replacing holistic, cradle-to-grave care with built-in continuity offered by traditional GP partnerships

ii. recognises that many practices and GP-led organisations may feel they have little choice but to engage further with their ICB’s plans, and in this context calls upon the GPC England officers to urgently create guidance for “ethical” frameworks of well governed GP-led at scale organisations where surplus must be reinvested back into member practices’ staff and services, in order to protect the independent contractor model of GP practices

iii. is concerned that the Secretary of State risks breaking his written promise to the profession of 18th March of a new GMS contract within this Parliament, and instructs the GPC England officers to immediately write, informing him what is required by the time the committee next meets, to avoid facing a return to dispute.

Source: GPCE motions seen by Pulse