GPC members query where BMA GP contract policy has come from

GPC members have queried where major policy proposals from the BMA to the Government’s ongoing 2026/27 contract negotiations have come from.

According to the chair of the England LMCs conference, Dr Clare Sieber, some of the demands are ‘not supported’ by union policy.

In a message to GPC and LMC representatives, seen by Pulse, Dr Sieber said she saw ‘two potential areas of contention’ across the proposals, which were published by the BMA last week following a meeting with the Government.

BMA policy is formed through motions to the Annual Representative Meeting (ARM) and the branch of practice conferences – including the LMC conference; and in matters where the branches of practice have ‘delegated authority’, this can be the final statement of policy on a subject.

Pulse also understands that the proposals had not been shared with the wider GP committee before publication, nor ahead of GPC representatives’ first consultation meeting with the Government that took place last Wednesday.

The proposals GPCE leaders have put to Government include replacing ARRS with a ‘practice level funding scheme’; increasing the Global Sum payment per weighted patient by £50 extra per patient specifically to grow the workforce; and introducing a clause to contracts requiring practices to ‘sign declaration letters’ confirming they have passed on the DDRB uplift to their employed GPs.

Dr Sieber questioned the demand for an increase of the Global Sum specifically tied to workforce growth, saying there is no LMC conference policy supporting such proposal.  

The proposal document said: ‘The increased investment of £50 per patient per annum would be used to explicitly grow an additional workforce, and provide additional hours from the existing workforce – by reducing the GP: Patient ratio, improving continuity of care, recruiting and retaining the UK-trained GPs we have invested in, and will ultimately deliver improved GP access to England’s population better than any practice-level incentive scheme or complicated sets of metrics.’

Dr Sieber said: ‘I can’t find any conference policy supporting the proposal to have the Global Sum uplift explicitly to grow an additional workforce.

‘In fact, there might be some policy for 2024 that can be interpreted as against this. Perhaps there is another mandate for these proposals from elsewhere? Although I don’t recall one from GPC England.’

In response in the message thread seen by Pulse, GPCE chair Dr Katie Bramall pointed to a GPCE motion from July.

However, one of the proposers of the motion – BBO LMCs chief executive Dr Matt Mayer – argued that whilst this had called for £50 extra per patient, it had meant for this to go into the global sum, rather than be ring-fenced for additional workforce.

The motion read: ‘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”.’

He said: ‘Whilst it is true that our motion called for “at least” a £50 uplift to “core” GMS, I can’t see any mention in the wording of any contingencies added to that sum such as mandatory criteria as to what it would have to be spent on. Indeed, a quick look at the BMA policy database makes it clear that existing conference policy is that funding such as ARRS should be injected “directly into practices to enable them to employ GPs as they wish” (England Conference, London, 2024), so I am surprised to see the qualifier added that this would be used “explicitly” for a single purpose.

‘I can see no conference policy, or GPCE policy, requiring funding to be ring-fenced to a specific purpose; I’d certainly be concerned that such a strategy would reduce our options.’

Dr Sieber also told LMCs that the proposal for DDRB uplifts to be mandatory in all contracts and for practices to sign a declaration of this ‘are not conference policy’.

She noted that a motion mentioning a ‘system for practices to be held accountable for non-payment’ was lost at the LMCs conference in November.

The BMA told Pulse that GPC England policies ‘are guided by committee and conference’, but ‘much is developed through the work of the GPCE officer team and BMA staff’.

A BMA spokesperson told Pulse: ‘Whilst GPC England policies are guided by committee and conference, much is developed through the work of the GPCE officer team and BMA staff, e.g. our manifesto www.bma.org.uk/patientsfirst.

‘Contract proposals are developed within the context of, and in response to counter proposals, which remain confidential.

‘GPC England’s priority remains ensuring practices are sustainable and the profession is supported at such a challenging time.’

As exclusively revealed by Pulse, instead of GP contract negotiations with the GPC, the Government is currently ‘consulting’ it alongside a wider group of stakeholders, including the RCGP and patient groups.