Nearly a third (31%) of GP partners in England would consider taking collective action in the form of shutting routine services for a week if funding is not significantly increased for 2024/25, a Pulse survey has revealed.
The survey of 362 partners in England reveals that there is an appetite among GPs to follow the leads of consultants and junior doctors in taking some form of action.
The survey revealed:
- 54% of GPs would consider shutting routine services for a day;
- 51% would consider lowering thresholds for referring to secondary care;
- 46% would consider undated resignations;
- 61% would consider diverting all on-the-day/urgent cases to 111 or A&E.
Negotiations for the 2024 GP contract in England are set to begin soon for an April implementation following NHS England’s ‘insulting’ offer for the 2023/24 GP contract.
The Government refused to increase the uplift beyond the 2.1% agreed as part of the five-year deal, despite huge increases in inflation. Last week, it said it was increasing practice funding but this was just to enable a pay rise for salaried GPs and other staff.
Legal experts have said GPs are able to take strike action and withdrawing services for a day is an option on the table.
However, for GP partners, shutting surgeries involves a significant financial hit as they will have funding removed but will still need to pay the salaries of staff.
Despite this, GP partners have said they are willing to take action.
Dr Pete Deveson, a GP in Surrey, said: ‘I would be delighted to join my junior and consultant colleagues in industrial action to improve the pay and conditions of NHS doctors, if such action could be effectively co-ordinated by the BMA.’
Some said that although they would like to strike, it would only add to GPs’ already unmanageable workloads, while others expressed concern about legal implications.
One anonymous GP said: ‘I’d be concerned about any walkout causing paused payments or fines, affecting practice income. We would be in a precarious financial position in this scenario.’
‘I’m also worried that NHSE/our ICB is waiting for practices to breach their GMS contracts in order to enforce an integration into the ICS and use current GP funding to plug the hole in failing social care and secondary care.’
One anonymous GP also expressed concerns about breaching contract, being fined or losing income, with one saying: ‘Industrial action is difficult, we do not have public opinion on our side at present. The workload is already overwhelming, stopping for a day would just add to work the following few days. I would not want to put patients at risk or overload secondary care.’
Another anonymous respondent said, ‘No-one will pick up any work we cancel – just making life even harder,’ while another added: ‘[There] would be no point diverting to 111 they would just send them back.’
Luton GP Dr Una Duffy said: ‘Among all the suggestions I have heard… I do not think anyone will pay very much attention. Public or politicians.
‘I think that GP industrial action should be deployed only as a nuclear option eg., a government decides to disband all GP partnerships and all must be salaried and work to a set rota. If it is a major, drastic change (not just a matter of insufficient funding), then a country-wide coordinated shutting of all GP practice doors would be the only industrial action that would be impactful. Not a skeleton or emergency only service. A complete shutdown. Other options are just tinkering at the edges.’
Another anonymous GP told Pulse that they were very keen that, with the Department of Health-driven shift in complexity of work to primary care, ‘we also move workload and put sufficient pressure on the 111 services, walk-in-centres, minor injury units, that funding needs to be [increased] to expand them, but any action certainly should not be at the expense of another department that is not designed to deal with primary care issues and is also on its knees’.
GP Dr Hana Harvey added: ‘It’s very difficult as we want to care for patients, but the recruitment issues and workload are unsustainable.’
Pulse’s survey was open between 9 and 15 June 2023, collating responses using the SurveyMonkey tool. A total of 362 GPs from across the UK responded to this particular question. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £250 John Lewis voucher as an incentive to complete the survey. The survey is unweighted, and we do not claim this to be scientific – only a snapshot of the GP population.
Would you be prepared to take any of these forms of industrial action if funding is not significantly increased in 2024/25?
Shutting routine services for a day
Don’t know: 14%
Shutting routine services for a week
Don’t know: 19%
Don’t know: 17%
Refusing to provide any non-contractual services
Don’t know: 8%
Lowering thresholds for referring to secondary care
Don’t know: 15%
Divert all on the day/urgent cases to 111 or A&E
Don’t know: 10%
Total number of respondents: 362
29 November 2023
29 November 2023
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