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
Yes: 52%
No 32%
Don’t know: 14%
Shutting routine services for a week
Yes: 31%
No: 50%
Don’t know: 19%
Undated resignations
Yes: 46%
No: 37%
Don’t know: 17%
Refusing to provide any non-contractual services
Yes: 80%
No: 12%
Don’t know: 8%
Lowering thresholds for referring to secondary care
Yes: 51%
No: 34%
Don’t know: 15%
Divert all on the day/urgent cases to 111 or A&E
Yes: 61%
No: 29%
Don’t know: 10%
Total number of respondents: 362
READERS' COMMENTS [11]
Please note, only GPs are permitted to add comments to articles
I’ll keep saying this ’til I’m hoarse——G.Ps swill not strike——–the last attempt folded almost immediately
THE DAILY NUTTER DO THE SAME….THEY HAVE GPs WHO DO PRIVATE WORK IN CENTRAL LONDON AND CHARGE MAMMOTH FEES AND LIVE IN MULTI-MILLION POUND HOMES AND RETIRED PRIVATE CONSULTANTS BOTH LECTURING NHS GPs ON WHAT VOCATION MEANS……….YES I KNOW. WHAT A SICK JOKE……THE INSANITY OF IT…………….THEY NEVER DISCLOSE TO THEIR READERS THAT THEY HAVEN’T SEEN ANY NHS PATIENTS FOR 30 YEARS AND……………….OF COURSE THESE INDIVIDUALS SHOULD BE REFERRED TO THE GMC BUT THE WHOLE SYSTEM IS CORRUPT………BUT THE TOP PEOPLE AT THE GMC ARE ALSO MULTI-MILLIONAIRES……………..
IN FACT IT MAKES SOME OF THE CRACKPOT REGIMES IN THE WORLD SEEM TAME IN COMPARISION……
Suspect a lot of people would fail to notice the local GP surgery closing for a week or two.
Meanwhile our PCN has more money than they can usefully spend, hence several not very useful schemes to spend it, with the usual time-wasting bureaucracy attached.
Although there is a lot of anxiety around striking and concern about its impact, I think we can certainly work to rule – ie work in line with the contract – ie work safely. We can restrict our patient contacts to the safe limit for a week and let 111 deal with the overflow. We should co-ordinate this with secondary care to make sure it gets the maximum impact.
When popularity of general practice is low, upsetting patients for not offering services will be unhelpful. Try and find some other way to negotiate.
Subhash – that’s the problem, this is a Govt imposed contract, not a negotiated outcome. The mood at he coal face is justifiably very militant nowadays. Cheers Guy
Tory scum dont negotiate they impose.
Agree NO strike which harms patients. Aside from the moral questionability it’s not a good look. We should however withdraw completely from all the dross that infests our working lives. PCNs, appraisal, revalidation, all data collection for outside agencies, CQC. None of this harms patients, in fact it will increase our availability to them, and we’d be dropping quite a lot of the crap that pisses us off about the job. Oh and Fuck The Tories. Thankyou.
No point making friends.We have been assaulted by the Tory propaganda rags for a decade.If we done act there will be no NHS/primary care to save.The medical profession will be drawn into a US style hmo health care system where the regulator will be used to quash any proffessional who doesnt know their place(more than it does now).There needs to be a united front, or we will find the profession as indentured surfs.
My partners and myself are more than happy with our current workload and conditions.Absolutely no need for any closures or other action which may harm patients.
We are all sick of hearing the incessant moaning of ungrateful GPs. Guys -if you cant stand the heat get out of the friggin kitchen….
I would suggest that most partners are not happy though Paul. There is a massive workload on the remaining (& shrinking) group of partners. I personally do not feel that partner income is the issue. I do feel though that partner numbers are.
We need to focus on emphasising the positive strengths of British General Practice, how it benefits the whole system, and how much work partners actually deliver for their money & how many more doctors would be needed to sustain a fully salaried service.
We also need to highlight that we are businesses & that we cannot be expected to just constantly absorb massive cost increases without receiving increases in income that reflect the real pressures. We cannot just put up our prices unilaterally & pass them on to the customer like other businesses have done.
We need recognition of the great work that real general practice delivers, a stop to diluting our numbers with use of other professional skills to allegedly do bits of our work (which does not actually reduce workload significantly), and a stop to GP bashing & raising undeliverable expectations by the politicians who are only interested in their votes at the next election.
General practice needs to be highlighted as the area of the NHS that is delivering over & above pre-pandemic workloads & that is the jewel in the crown of the NHS & a place where all young doctors should aspire to work.