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GP leaders face tough decision on industrial action in November



The BMA’s GP Committee is to decide in November on its next steps towards industrial action after its own survey found over half of GP practices would be willing to temporarily stop registering patients due to workload pressures.

GPC chair Dr Richard Vautrey told Pulse that ‘all options are on the table’, including potential industrial action that would involve balloting GP practices on whether to close their lists en masse.

The meeting of GPC England will consider whether the Government ‘are taking seriously’ the pressures in general practice and the results of its survey.

It conducted the survey to gauge whether there was any appetite for industrial action, following a motion at this year’s LMCs Conference.

The survey drew responses from 1,870 GP practices in England, the BMA’s GP Committee said, revealing that 54% would be willing to close lists to ‘focus on delivering safe care to patients already on their practice list’.

In addition, 44% of practices said they would be in favour of applying for a formal and permanent list closure from NHS England.

The GPC said the next step would be to take the result and bring it into negotiations with Government about GP terms and conditions.

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Dr Vautrey told Pulse there were no immediate plans to ballot the profession on industrial action but ’all options are on the table’.

He added: ’It will be GPC England in November that will be considering the response that the Government are making, whether they are taking this issue seriously but it’s an issue for GPC England.

‘We will see what will happen over these coming weeks but when we get to GPC England it will be for them to consider what are the next steps based on the information that they will be receiving from their own constituents.’

He added that in places such as Folkestone, ‘practices are now reaching the point where they are closing their lists because they want to keep their patients safe’.

The Department of Health acknowledged that GPs ‘are under more pressure than ever’ but urged the BMA to consider how patients would fare if it were to put its threat of collective practice list closures into action. It suggested last year’s GP Forward View rescue deal was resolving the problem.

A DH spokesperson said: ’We are backing the profession with an extra £2.4bn of funding for general practice by 2020.

‘We speak regularly to the BMA about issues concerning general practice and would urge them to consider the detrimental impact which list closures could have on patient care.’

The BMA’s survey asked whether funding, workload and staffing pressures meant they needed to consider suspending new patient registration in order to protect patient safety.

It came after a motion at the LMCs Conference in Edinburgh this year stated it ‘demands that GPC ballot GPs as to whether they would be prepared to collectively close their lists in response to this crisis’.

At the time, now-GPC deputy chair Dr Mark Sanford-Wood warned that there were ‘risks’ with the plan, and that such action would ‘likely be a breach of contract’.

What happens next

The GPC is set to take the results of its survey into negotiations with the Government. This month it is also expected to update its Urgent Prescription document – its list of demands for general practice – which it will relay to NHS managers.

GPC England will meet in November and decide whether the Government’s response to its demands has been sufficient. GPC chair Dr Richard Vautrey said ‘all options are on the table’.

For any ballot result to be legal, a turnout of at least 50% will be needed, with the majority of those voting in favour of action. Recent changes to trade union law also specify the support of at least 40% of all members entitled to vote (ie, on an 80% turnout, a 51% vote would be acceptable).

There have been indications of how such action would be received, with an unusually measured Daily Mail front page saying GPs were considering taking the ‘drastic’ measures because of the pressure they were under.

But there is the possibility many practices will unilaterally close their lists anyway on the basis of GPC advice they have already received.

The idea of a mass closing of lists was first suggested by Pulse editor Nigel Praities.