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Trusts dumping workload on GPs should face cash penalties, say LMC leads

Hospitals that shift work onto GPs should be fined, GP leaders have said. 

LMCs called on the BMA GP Committee at their annual conference to impose ‘financial penalties when standard hospital contracts are breached’ and workload dumped on GPs. 

They also asked for appropriate funding to be transferred to general practice with ‘each identifiable breach’, with countering measures to be fully implemented by NHS England in the upcoming contract negotiations.

Presenting the motion, Dr Aaron Brown, from North Yorkshire LMC said: ‘The contract that the BMA negotiated to reduce our workload dump has failed […] but it’s also backfired badly.

‘It has added fuel to the fire that trusts say they are highly compliant with the BMA standard contract. I thank the BMA and the GPC for their attempt to help us but the black and white rules they produce are being ignored on a daily basis.

‘Every single GP in this room can probably recall at least one example in the last week of these rules being breached. Those who cannot are likely a victim of doing unfunded work so often it’s become white noise.’

In response, BMA GP Committee deputy chair Dr Mark Sanford-Wood said: ‘We’ve been engaging with NHS England around policing this and we’re keen to continue to work with LMCs.

‘We support the sentiment of this motion [but] the enforcement of the standard NHS contract isn’t something that we discuss or negotiate within the GMS contract because they’re separate things. We do need to engage with NHS England around proper enforcement of the standard NHS contract.’

As part of the GP Forward View, published in 2016, NHS England changed trusts’ standard contract to prohibit them from sending patients back to GPs unnecessarily.

But a recent Pulse investigation revealed the measures appeared to have made little difference, as data shows around 45% of patients who miss their first hospital appointment being sent back to general practice


That conference is deeply concerned at the flagrant continued contravention of the standard hospital contract and asks GPC England to develop proposals to counter this including:

i. a formal audit of unresourced work that should be done elsewhere 


ii. transfer of appropriate funding to general practice with each identifiable breach


iii. financial penalties when standard hospital contracts are breached


iv. full enforcement by NHS England as a red line in the 2020/2021 contract negotiations.