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BMA day of action: how the day unfolded

Thursday 21 June

17.00 NHS Employers have issued a statement. Director Dean Royles said: 'We genuinely feel for and share the distress of the thousands of patients that have been affected by this industrial action. This action is not fair on them. We are of course relieved that the strike does not appear to have been as damaging as had been feared. The good news is it looks as if the careful planning has paid off and that means employers have generally been able to minimise the damaging effect on patients.'

16.57 Our online intern went down to the protest at Tower Hamlets and shot this video:

16.50 Dr John Canning, Cleveland LMC chair and member of the BMA pensions committee, said the day ‘was not the BMA's greatest'. He said: ‘On local radio, there were a few supportive voices but the vast majority were not supportive. It's not been an absolute disaster, but it hasn't been our greatest day.  ‘The anger and frustration… is as strong as possible. I think people are anxious about how you demonstrate that firstly in terms of affecting patients, and secondly without making life harder tomorrow. There has also been a bit of fear about what constitutes breach of contract.'

16.17 NHS London has said it misreported its original figures on the numbers of GP surgeries taking action. It originally said 17% of surgeries were taking action, but it has since said there 23% would be treating only urgent cases.  However, in the North East region, this number is 15% - 60 out of 400 practices. Newham PCT in east London has reported some of the lowest figures, with only 5 out of 64 practices taking part. 

14.55 Veiled threat from Mr Lansley on the BBC: 'If doctors don't increase their contributions, then that would have to be met by other NHS staff'.
Dr Laurence Buckman on the BBC: 'There is very little we can do that won't affect patients in an adverse manner'.

14.35 Dr Manoj Pai, a GP in Coventry and a former Coventry LMC chair, said patients had been very understanding. The three doctors in the practice have seen around 10 to 12 urgent patients between them, Dr Pai said. 'It's a token protest because we are still seeing urgent patients. I think the patients have been supportive,' he added

14.17 Blogger update:

Jobbing doctor

Well, that's the morning over and done with.

There has been solidarity within the practice, and we are only seeing immediately necessary and urgent patients. The local primary care trust has been ringing around to find out if we are taking industrial action. I wonder if we will end up in some 'naughty doctors' book"? We are likely to face a financial penalty.

The morning has been very quiet indeed with each doctor only seeing a handful of patients. One of my colleagues saw four patients and three of them were ill. That is quite unusual. It feels like old fashioned general practice.

I am not looking forward to tomorrow when we will be inundated with work. Will the PCT be ringing around and offering to pay us double?  Dream on.

Read Jobbing Doctor's ongoing account of his day of action.


13.45 The practice of GPC deputy chair Dr Richard Vautrey is one of thousands across the country which has rejected the BMA's call to industrial action, Pulse can reveal. The Meanwood Group Practice in Leeds said it was unaffected by industrial action and was performing routine appointments as normal. Dr Vautrey, who was not at the surgery today, declined to say why his practice had decided against joining the BMA action, but told Pulse: 'I'm taking part, and that is the important thing. I'm here in London speaking up for GPs' rights across the UK.'

Read the full story here.


12.49 Dr Beth McCarron Nash, a GPC negotiator, is in her surgery today and says she has been doing press and radio interviews for the past four days. The practice has taken action and is seeing urgent patients, and she says she's been really pleased with the support from her patients.

'Patients understand the unfairness of the situation but it's not a race to the bottom as we explain to patient, we've already made the hard decisions on pensions during the renegotiations four years ago and being asked to accept more cuts is not on.

'It's not about doctor's salaries or their perception of what we earn, it's about fairness. A lot of the myths in defence of what the government is doing just aren't working out because we're getting our message across.'

11.40 An update from 'GPs to be' blogger Dr Avradeep Chakrabarti: 'Morning surgery has not been too busy. I actually had a few free slots! My trainer says less than 25% of practices in the area are striking. Since there is normal service at this practice, my on-call this afternoon is probably not going to be any worse than normal.'

11.39 NHS London has said that 83% of its 1477 surgeries are 'operating normally' today. It could not verify whether this meant that no GPs within the practice were taking part. However, even if this were the case, this is a higher percentage than the rest of the country, suggesting NHS London's letter regarding possible sanctions put GPs off taking action. More to follow...


11.20 The BMA are indicating that a third of surgeries have been affected by the action. This includes a mix of surgeries taking full action and those taking partial action. The Department of Health is currently collecting its own figures. Read more here.

11.13 Dr Georgina Brown, vice-chair of the Glasgow LMC and a GP in Glasgow, said that patients have been very supportive of the action taking place at her surgery. She added that numbers of urgent cases are lower than normal. 'Patients are not cheating the system. Most have said they will phone back the following day. A handful said it was urgent, but we helped them over the phone, as we would on any other day.'

10.45 Today's industrial action, and the publicity surrounding it, is having an impact even on those practices who have decided not to take part. 

On Twitter, Dr John Bye reports that even though his surgery is not taking action he has had three DNAs this morning, which for his practice is unusually high. 'Wonder if they've heard the headlines?' he asks.

10.40 An update from our ‘GPs to be‘ bloggers, who, as GP trainees, aren't taking industrial action today.

Dr Martin Wicks is working in A&E: He says: ‘I think an unprecedented amount of people will present to A&E because they cannot see their GP, so it is going to be a busy day…'
Dr Avradeep Chakrabati's practice is not taking industrial action: ‘Business as usual. I'm on-call in the afternoon for emergencies though- expecting it to be busy!'
Dr Julie Fry is not a BMA member so she's not taking part – in fact it's her end of year review today. Wish her luck!

10.27 The BMA and the Department of Health do not have figures about how many surgeries are taking action. Both say they expect figures later today. The Pulse story from Monday suggests 22% of surgeries are taking action, and anecdotal evidence today suggests this not far off.

10.23 Dr Russell Brown, a GPC member and chair of East Sussex LMC, is taking industrial action and has made an urgent 2-week-wait cancer referral this morning but otherwise hasn't seen many patients.

'People seem either happy to wait until another day or get seen as urgent,' he reports. 'A couple have rung just to wish us well!'


10.15 Dr George Rae, a GP in Newcastle who is running for chairman of BMA council, said that 25% of surgeries in North of Tyne are taking action. However, he added, many of those not taking action are still supportive of the BMA's stance and are explaining the issue to patients. 'One surgery phoned me earlier this week to say they were split 50/50 on whether to take action. They decided to do appointments as usual but will explain the pensions issue to patients,' Dr Rae said.


10.06 The BMA has its own live-blog up and running, and has just announced that 'initial reports from GP practices around the country suggest all is quiet and patients are staying away'.  There are no official figures yet for the proportion of practices which will be taking action, but the BMA's eve-of-action statement did claim that 'at least four in five NHS employers in secondary care have postponed some non-urgent cases'.
09.58 Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, north London, said the action was 'running smoothly'. He added: 'Paradoxically, there is greater capacity for access for same-day urgent patients. We're seeing the number of patients we would have expected. Patients are well aware of the message we are trying to get across.'

09.56 The Pulse team is hitting the phones, but much of the early feedback is still coming through on Twitter - and psychiatrist Dr Alice Lomax makes an interesting point. She says she that taking industrial action is 'something I never thought I'd do' - but adds that as of yesterday evening her urgent assessment slots for today were already half-full.


09.08 A key question today will be how many GPs and other doctors actually take action. The Telegraph splashes this morning on one estimate, claiming that two thirds of doctors are 'in retreat'. 

Their ringround of 20 PCTs yesterday found that on average two thirds of GP practices had reported that no doctors would be taking industrial action - seeing if those figures are reflected nationally will be crucial.

08:40 Dr Hamish Meldrum on the BBC this morning: 'We are not out to make patients suffer. They are dealing with all emergency and urgent work, it is just some routine work that is being cancelled.'

08.30 The first day of industrial action by doctors for almost 40 years is upon us - and Pulse will be covering it live throughout the day. Let us know what's going on - or what's not going on - at your practice, by email at or in the comments below.

Wednesday 20 June

17.29 Lansley brands 'the strike [is] pointless' and urges doctors to 'to think again before taking part in a strike that will inevitably damage the services for patients' at NHS Confed. After the conference he spoke to Pulse saying it would be 'even more perverse' if doctors opted to pursue further action that involved withdrawing their co-operation from clinical commissioning.

16.45 As the day of action approaches, debate on Twitter between GPs for and against taking industrial action is reaching fever pitch. GP comedian Dr Phil Hammond is one of those who won't be taking action:




14.00 Lansley speaks at NHS Confed. Twitter respond to his comments on pensions and tomorrow's day of action:




12.15 Foreign secretary William Hague, standing in for David Cameron at Prime Ministers Questions today, accused Labour of being divided over support for the pensions strike. Using quotes given to Pulse by Diane Abbott, shadow health spokesperson, Hague jumped on shadow deputy PM Harriet Harman's claim that Labour do not want to go on strike. '[Harman] should tell that to her own spokesman, Diane Abbott, who said she had a lot of sympathy for doctors and said they would get a lot of public support for the action they are taking, so there is a clear division across the floor of the house,' Hague said.

11.00 To kick off our live coverage of tomorrow's events, the news revealed in Pulse that only one in four practices will take industrial action has made it into most of the national papers.