An overwhelming majority (98.3%) of GPs balloted by the British Medical Association (BMA) have voted in favour of taking 'collective action'.

The BMA will therefore be encouraging the profession to pick from a list of actions to take from today (1 August).

The proposed action includes limiting daily contacts per clinician to 25 and switching off the  GP Connect Update Record functionality that permits the entry of coding into the GP clinical record by third-party providers.

Dr Katie Bramall-Stainer, chair of BMA's GP committee for England (GPCE), said the action was 'an act of desperation' on the part of GPs.

'For too long, we’ve been unable to provide the care we want to. We are witnessing general practice being broken,' she said.

But she suggested that the 'slow burn' approach would mean the impact of the action 'may not be felt for some time'.

'We hope this will give the new government time to consider our proposed solutions including fixing our contract once and for all,' she said.

The action begins as the government has this morning announced that £82m 'from the existing department budget' will be used to fund over 1,000 GPs as part of the Additional Roles Reimbursement Scheme (ARRS), as an 'emergency measure' for this year while longer-term funding is worked out.

GP funding will also be increased to boost salaries of GPs and other employed practice staff by 6%, the government announced this week.

Dr Bramall-Stainer described the pay award as 'a small a step in the right direction', but said general practices 'still have hundreds of millions less resource' than they did 'even five years ago'.

'Practices are still closing, so we have no choice but to move ahead with collective action to protect our practices, and our patients,' she said.

Out of 12,590 eligible voters, 8,518 GPs responded to the BMA ballot, which was carried out between 17 June and 29 July 2024 - a 67.7% turnout.

Of those, 8,375 voted 'yes' to the question: 'Are you prepared to undertake one or more examples of collective action as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice?'

And 143 (1.7%) voted no. There were no spoilt ballots.

The GPCE is encouraging practices to 'pick and choose' which actions they take, and may increase their actions over time.

The news comes amid ongoing delays to the community pharmacy contract, which some say are causing more and more pharmacy closures.

 

What actions can GP practices choose from?
  1. Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25. Divert patients to local urgent care settings once daily maximum capacity has been reached. We strongly advise consultations are offered face-to-face. This is better for patients and clinicians
  2. Stop engaging with the e-Referral Advice & Guidance pathway - unless for you it is a timely and clinically helpful process in your professional role​.
  3. Serve notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of your business and staff.
  4. Stop rationing referrals, investigations, and admissions​
    - Refer, investigate or admit your patient for specialist care when it is clinically appropriate to do so. ​
    - Refer via eRS for two-week wait (2WW) appointments, but outside of that write a professional referral letter in place of any locally imposed proformas or referral forms where this is preferable. It is not contractual to use a local referral form/proforma – quote our guidance and sample wording
  5. Switch off GPConnect Update Record functionality that permits the entry of coding into the GP clinical record by third-party providers.
  6. Withdraw permission for data sharing agreements that exclusively use data for secondary purposes (i.e. not direct care). Read our guidance on GP data sharing and GP data controllership.
  7. Freeze sign-up to any new data sharing agreements or local system data sharing platforms. Read our guidance on GP data sharing and GP data controllership.
  8. Switch off Medicines Optimisation Software embedded by the local ICB for the purposes of system financial savings and/or rationing (rather than the clinical benefit of your patients).
  9. Defer signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance is available. In the meantime:
    - Defer signing off ”Better digital telephony” until after October 2024: do not agree to share your call volume data metrics with NHS England.
    - Defer signing off “Simpler online requests” until Spring 2025: do not agree to keep your online triage tools on throughout core practice opening hours, even when you have reached your maximum safe capacity.

  10.  Defer making any decisions to accept local or national NHSE Pilot programmes whilst we explore opportunities with the new Government.

    Source: BMA