If GP leaders have made a mistake, we need to know

Pulse editor Sofia Lind on the importance of clarity before GPs are asked to escalate the online access dispute.

There are weeks in general practice when the detail matters more than anything else. A stray line in an email. A claim made in a meeting. A clarification that never quite arrives. This has been one of those weeks.

After the events of last weeks’ England LMC conference – where a bunch of motions escalating the dispute with Government around online access requirements were passed; and the GPC chair accused ministers of ‘lies’ – the Government has now pulled all meetings with GPC England.

Apparently an edict directly from Wes Streeting, it seems they’re no longer seeing an amicable way out. GPC leaders say this shows they have hit a nerve. But amid all this, the profession is now needing answers from both sides.

The Department of Health and Social Care has released written evidence showing that GPC’s executive was told, in clear terms, that the October online access requirements would go ahead without software safeguards. The same email says practices themselves would be responsible for discouraging patients from submitting urgent requests.

Many members of GPCE tell us they did not see this before they voted to accept the contract terms, and that they feel misled. Some blame cock-up, others have come with conspiracy theories.

When I asked the BMA press office for their side last Friday morning, I expected a straightforward explanation. Instead, we have seen a week of mixed signals and defensive messaging.

The executive has issued statements, but not the explanation they promised, and the repeated suggestions that one is ‘coming soon’ are beginning to look less like reassurance and more like avoidance.

A message sent privately by Dr Katie Bramall to LMC leaders, which I have seen, did not settle things. It expressed understandable frustration at press briefings and defended the executive’s interpretation of events.

It described the Government’s email as ‘subsequent’ and ‘informal’, and said that a later meeting reassured them that no single software solution could be mandated, so mitigations would need to be bespoke and worked through with providers. That may well be an honest account of what was understood at the time. But it does not answer the real point, which is why a contract was agreed before any of these mitigations were secured – and crucially why the wider committee was not informed of the caveats.

This matters because the 1 October requirements are not a footnote. They are a major shift in how practices run day to day. As our survey revealed, practices are already losing about 200,000 appointments a week because of it.

The message I’m reading between the lines is that this was probably a mistake – a misreading of the impact of what was to come – and I think the GPCE exec do feel badly let down by the Government. Saying that openly would help the profession far more than hints of a fuller explanation to come.

None of this excuses ministers and their apparent disregard for the unintended consequences of unlimited patient access. Cancelling meetings is a performance that does nothing for patients. And the BMA is now doing essential work: collecting data and building its evidence base – with survey result on the impact that I’m hoping we’ll be able to report on next week.

That is constructive and much needed, but future work by the GPCE – whether that’s getting the Government back into talks, or organising a ballot for collective or industrial action – needs to be underpinned by honesty about how this situation arose.

Setting that out plainly would not weaken the GPCE. It would strengthen its hand. Clarity now is the only way to rebuild trust and give the profession the footing it needs for whatever comes next.