Exclusive: Fresh bid to trigger industrial action ballot for GPs in England

LMCs in England could again call for industrial action in response to the GP crisis later this year.

GP leaders in London are preparing fresh proposals for this year’s annual LMCs conference which could trigger a ballot for a collective list closure to ensure patient safety in the face of the continuing crisis in the service.

The motion, being prepared by Tower Hamlets LMC, would call on GPC England to publish a paper comparing the demands in its Urgent Prescription with the concessions announced in NHS England’s GP Forward View. The GPC would be asked to survey GPs on whether they believe their demands have been met, and if not, the motion will say, there should be a ballot for collective list closure to ensure patient safety.

LMC chair and GPC member Dr Jackie Applebee told GPonline she would not argue for mass contract resignations, as planned in Northern Ireland, because she believed that could be a ‘dangerous’ step.

Londonwide LMCs chief executive Dr Michelle Drage, a vocal critic of the GP Forward View, said she believed the situation for GPs and their mood had not much changed since LMCs voted for a mass resignation and industrial action ballot last May. ‘Anything could happen this conference,' said Dr Drage.

GP industrial action

GP representatives agreed overwhelmingly last year a plan moved by Dr Applebee to give the government and NHS England three months to accept Urgent Prescription demands. Failing that, the GPC was told to ballot GPs on their willingness to submit undated mass resignations, on what forms of industrial action they would be prepared to take and to draw up a report on other forms of legal industrial action.

The ballot was scrapped by the GPC in August, a week after the three-month deadline passed, when NHS England agreed to accept the Urgent Prescription as a 'basis for further discussion'.

Dr Applebee said at the time GPs would feel 'cheated' out of the industrial action vote without quick, concrete proposals from NHS England, and pledged to continue to push the GPC for a ballot if action from NHS officials was not forthcoming.

The GPC said last month it was continuing discussions with NHS England to ensure it honours commitments in the GP Forward View, which promised an additional £2.4bn a year in GP funding by 2020/21, and proposals being taken forward from the Urgent Prescription. The GPC has said it would push for front-loading of the GP Forward View funding increase, the replacement of the CQC inspection regime, and for a cap on daily patient numbers.

Responding to question on a BMA GP contract webchat, GPC chair Dr Chaand Nagpaul said the Urgent Prescription was ‘already being implemented’ with all recommendations ‘being considered’.

GP contract

‘The ending of the [Avoiding Unplanned Admissions] DES, indemnity costs and reimbursement of CQC was a [Urgent Prescription] recommendation,' Dr Nagpaul said.

‘We are in dialogue with implementation of our safe working model, and also there will be further requirements on stopping secondary care inappropriate workload shift as of April 2017- NHS England is specifically referring to our [Urgent Prescription] in making these changes. Also many [Urgent Prescription] priorities are already in the GP Forward View and we are putting in place measures via LMCs (we have sent out a template) to monitor local implementation to hold NHS England to account.’

Dr Drage, who also sits on the GPC, said the situation for GPs ‘as we saw it at the annual conference of LMCs in May hasn't in and of itself changed’.

‘I remain critical that [the GP ForwardView] isn't enough to do the job. We haven't seen delivery yet,’ she said. ‘In the grand scheme of things, what there is is a drop in the ocean.’

GP crisis

An RCGP progress report in January criticised progress on delivering the practice resilience element of the GP Forward View, which promised extra resources to help vulnerable and struggling practices. The college, which was badged as a partner in the GP Forward View, said progress on the scheme was ‘extremely disappointing’ while significant numbers of practices remain at risk of closure. Chair Professor Helen Stokes-Lampard said while there had been some positive progress on implementing the Forward View plans announced last April, there remained a ‘huge amount’ to do at local level to ensure GPs notice improvements.

The Londonwide chief executive said that while there had been some recognition by NHS bosses that the system could not work without general practice, LMCs’ response would depend on how measures in the GP Forward View were being implemented locally.

The mood among GPs, she said, had not changed since last year. ‘I think it is still there, and I think it will depend on what happens between now and May as to whether that mood remains and how far it goes.’

‘Anything could happen this conference,' she added. The NHS, said Dr Drage, had been ‘lucky to get away with’ the ballot not being held last year.

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