GPs could demand payment for any new work transferred from hospitals

GP leaders will vote on demanding payment for any additional work transferred to general practice from secondary care.

At their national conference in Glasgow next month, LMC representatives from across the UK will vote on a motion recognising Government ‘ambitions’ to shift more care into the community and demanding ‘appropriate’ payment for any work transferred to practices as part of this.

The motion demands that any ‘substantial’ new GMS contracts contain provision for payment to practices, on an item of service ‘or similar basis’, for all ‘identified work’ transferred from secondary care.

It also calls for funding streams to be allocated to support ‘any current and future shifts’ in patient follow-up responsibilities, ensuring primary care is ‘not expected to absorb additional work without appropriate resourcing’.

The BMA should also create a working group to define core general practice obligations to inform contract negotiations, as it is ‘more important than ever’ to define what general practice should be expected to deliver for patients, the motion added.

It said: ‘Conference recognises the ambitions of governments to shift medical provision from secondary into primary care and calls for targeted training and education for secondary care clinicians to ensure a better understanding of primary care capacity and contractual boundaries, reducing inappropriate workload shift.’

At the conference, GP leaders will also debate GP unemployment, with one motion condemning the ‘continued unacceptable situation’ and calling on governments to expand the flexibility of the SFE locum reimbursement scheme to enable practices to claim for locum reimbursement.

Another motion included in the agenda calls for an independent review of the impact of physician associates working in general practice.

LMC representatives will also discuss assisted dying, artificial intelligence, PSA screening, weight-loss medication prescribing and monitoring, as well as a call for the GP committees to adopt a position rejecting any shared care prescribing arrangements with private providers (see box).

The conference agenda also includes a motion already debated by LMC representatives in Wales, calling for all GP partners to undertake ‘a minimum number of clinical sessions’ in their practice annually, including face-to-face appointments.

The motions in full

Weight loss medication

HAMPSHIRE AND ISLE OF WIGHT: That conference notes with concern the increasing trend of unregulated online prescribing of GLP-1 receptor agonists for weight loss and calls for:
(i) GPC(UK) to push for an urgent and thorough review of the online prescribing practices of GLP-1 weight loss drugs by Medicines and Healthcare products Regulatory Agency (MHRA) and the Care Quality Commission (CQC), ensuring that patient safety is not compromised
(ii) regulators to develop clear guidelines for the prescribing and monitoring of GLP-1 receptor agonists, particularly when initiated online, to safeguard patient health and ensure appropriate clinical responsibility
(iii) robust national protocols that clearly delineate the responsibilities of online prescribers and GPs, ensuring that GPs are not left with the burden of monitoring and managing these medications without adequate resources and support
(iv) a UK wide public awareness campaign to educate patients on the risks associated with obtaining weight loss medications online
(v) a nationally commissioned obesity management service to ensure equity of provision to the most clinically at risk, rather than those with the highest perceived need.

Private shared care

AVON: That conference believes that any shared care prescribing arrangement with a private provider is
unsafe, not enduring, and widens health inequalities, and demands that GPC UK adopts a firm position
statement to reject this.

Mental health and wellbeing support

WEST SUSSEX: That conference calls for the establishment of confidential, dedicated mental health and well-being services for all general practice staff, recognising the unique pressures faced by GPs and their teams and:
(i) acknowledges that burnout rates in general practice have reached crisis levels, yet targeted mental health support remains insufficient
(ii) demands that mental health and well-being services for general practice staff be fully funded, easily accessible, and independent of regulatory or contractual oversight to ensure confidentiality
(iii) calls for parity between general practice and secondary care in the provision of occupational mental health support, recognising the critical need to retain and protect the workforce
(iv) urges NHS England and the devolved nations to implement a national strategy addressing mental health support for all primary care staff as a matter of urgency.

Unemployment crisis

SESSIONAL GPS COMMITTEE: That conference condemns the continued unacceptable situation of GP unemployment and calls on governments to expand the flexibility of the SFE locum reimbursement scheme to enable practices to claim for locum reimbursement:
(i) whilst actively recruiting for a GP for up to 12 weeks
(ii) from day one of absence of a GP.

Physician associates

LOTHIAN: That conference insists that physician associates should not be seen as a cheap replacement for general practitioners and calls for an independent review on the impact of physician associates working in general practice.

Assisted dying

AGENDA COMMITTEE TO BE PROPOSED BY WELSH CONFERENCE OF LMCs: That conference, with regards to any assisted dying legislation becoming law:
(i) believes that GPs must not be compelled to participate in or initiate discussions about assisted dying and calls for protections to ensure professional autonomy is upheld, with no risk of professional sanction or discrimination
(ii) demands that the provision of effective and properly resourced palliative care be delivered in addition to the option of assisted dying
(iii) demands that funding will be new rather than removing resource from existing care
(iv) recognises that there is no capacity within general practice to take on this additional work
(v) demands that the medical involvement for this should sit with a separate service and not general practice.

Data controller

AGENDA COMMITTEE TO BE PROPOSED BY CLEVELAND: That conference recognises that increased crossorganisational information sharing may bring increased liability and risk to fall upon GPs and therefore demands that the legal responsibility of being the data controller is removed from general practice.

AI in general practice

AGENDA COMMITTEE TO BE PROPOSED BY WEST SUSSEX: That conference supports the use of artificial intelligence (AI) in general practice, for instance for transcribing notes and:
(i) calls on GPC to advocate for these technologies to receive national assurance in the form of Data Protection Impact Assessments (DPIAs) and other necessary evaluations, so that practices do not need to repeat these assurance processes locally.
(ii) calls on relevant NHS bodies to urgently fund and implement AI scribes in general practice
(iii) insists that robust data protection and governance frameworks be established to ensure patient confidentiality and compliance with GDPR and NHS regulations
(iv) calls for transparent regulatory oversight and ongoing evaluation of AI applications in general practice to ensure they improve patient care and do not exacerbate health inequalities.
(v) demands clear medico-legal protections for GPs, ensuring they are not held liable for AI-driven errors or outcomes beyond their control.

PSA screening and monitoring

SURREY: That conference is concerned by the increasing workload burden on general practice due to the unresourced and un-evidenced expansion of PSA testing and monitoring, driven by secondary care and local advocacy groups and:
(i) calls for recognised funding to support the growing expectation for GPs to provide PSA testing, counselling, and long-term monitoring, including post-treatment surveillance for discharged prostate cancer patients
(ii) opposes the transfer of routine PSA monitoring from urology services to general practice without clear evidence, agreed guidelines, and appropriate funding
(iii) calls for a national review of PSA screening and monitoring pathways, ensuring that primary care is not burdened with additional work without adequate resources
(iv) calls for national bodies, including NHS England, to push back against the pressure exerted by local prostate cancer charities to increase PSA testing without robust evidence or national policy support.

GP partner clinical commitment

WELSH CONFERENCE OF LMCs: That conference:
(i) is concerned by the number of GP practices in Wales with GMS contracts held by GPs who perform no clinical sessions in those practices
(ii) calls for all GP partners to undertake a minimum number of clinical sessions in their practice annually, including face-to-face appointments, while appropriately accounting for circumstances such as parental or sick leave
(iii) calls for commissioners to refrain from awarding multiple GMS contracts to the same individuals who are unable to provide clinical care across all of their practices
(iv) asks for a change in regulations to ensure that GP partners awarded GMS contracts are required to regularly provide clinical sessions in their practices

Defining core general practice

AGENDA COMMITTEE TO BE PROPOSED BY CAMBRIDGESHIRE: That conference recognises the ambitions of governments to shift medical provision from secondary into primary care and:
(i) believes that it is more important than ever to define what general practice should be expected to deliver for patients
(ii) calls for targeted training and education for secondary care clinicians to ensure a better understanding of primary care capacity and contractual boundaries, reducing inappropriate workload shift
(iii) asks the BMA to create a working group to define core general practice obligations in the UK, to aid GPCs in national contract negotiations and protect general practice from being forced to absorb unfunded work streams
(iv) demands that funding streams be allocated to support any current and future shifts in patient follow-up responsibilities, ensuring primary care is not expected to absorb additional work without appropriate resourcing
(v) demands that any substantial new GMS contracts contain provision for payment to practices, on an item of service or similar basis, for all identified work transferred from secondary care.

Source: BMA

Following a vote at a recent special LMC conference, England’s GPs may be asked to join ‘peaceful protests’ organised by the BMA to highlight pressures in general practice.

On the day of the special conference, health secretary Wes Streeting provided the GPCE with a written commitment to negotiate an entirely new GP contract for England by the end of this Parliament – which was a precondition for the BMA’s acceptance of 2025/26 contract changes.

England’s GP leaders also voted for a motion which advises all practices to now issue an ‘indefinite’ fit note on a patient’s first presentation, meaning all further fitness-for-work assessment is passed on to the Department for Work and Pensions.