BMA delivers vote of no confidence in NHS England over failure to support GPs

BMA GP leaders have delivered a damning vote of no confidence in NHS England amid widespread anger over a letter ordering practices to offer all patients face-to-face appointments.

The BMA GP committee for England voted to pause all meetings with NHS England and demanded an explanation over the ‘tone deaf' letter.

The vote - which GP leaders said must be a 'wake up call' for NHS England's leadership - comes after a petition calling on NHS England's primary care medical director to resign gathered more than 1,100 signatures in a few days.

BMA GP committee chair Dr Richard Vautrey said: 'For the representatives of England’s GPs to pass a vote of no confidence in NHS England’s senior leaders is a clear wake-up call to NHS England and also for the government.

GP anger

'Without doubt, the motivation for this comes entirely from the widespread anger, frustration and disappointment felt by tens of thousands of GPs about the cavalier ways in which they have been treated and badly let down by the government and NHS England.

'These organisations have repeatedly failed to resolve the crisis of falling numbers of GPs who are trying to make inroads into a mammoth backlog of patients needing care, but also properly recognise and celebrate the incredible contribution of general practice throughout the pandemic and the vaccination programme.

'Last week’s woefully badly judged letter from NHS England was the final straw for many hard-working GPs who have gone above and beyond over the last year. They have continued to provide care for their patients under the most difficult circumstances, only for their efforts to be undermined and instead issued with a public rebuke which also inferred that surgeries had been closed to face-to-face appointments.'

Dr Vautrey said the claim that practices had been closed through the pandemic 'could not be farther from the truth', with official figures showing that practices delivered 164m face-to-face patient appointments between March 2020 and March 2021 - in addition to millions more appointments delivered remotely and millions of in-person contacts as part of the COVID-19 vaccination campaign.

Face-to-face appointments

BMA vice chair and Lancashire GP Dr David Wrigley said the GP committee meeting had heard about GPs 'breaking down' due to intense workload and a lack of support, with some 'driven to self harm'. 

GPonline reported earlier this month that numbers of GPs per patient in England had fallen by 10% over the past five years, as GP numbers have dropped and patient numbers have risen.

Workload in general practice has hit unprecedented levels during the pandemic, with official data showing a 20% rise in appointments in March compared with the previous month - and RCGP data showing that practices delivered a third more clinical administrative work in the early weeks of 2021 compared with last year.

The BMA has already demanded an urgent meeting with health and social care secretary Matt Hancock over the escalating dispute around face-to-face appoinments and demands for more support for general practice.

Dr Vautrey added: 'For NHS England to glibly announce that practices should now see even more patients face-to-face without providing anything in the way of extra support or guidance on how to continue to protect patients and staff from the risk of a potentially lethal virus, is at best nonsense, but at worst extremely dangerous.

NHS England demands

'The profession has had enough of ill-conceived top-down directives that fail to consider the day-to-day reality in scores of doctors’ surgeries. We know that some patients are frustrated at long waits for treatment or being unable to get a face-to-face appointment when they’d prefer one.

'GPs everywhere share that frustration. This is not the fault of individual practices or doctors, and instead of issuing tone deaf letters, in what seems to be a reaction to media coverage, rather than based on the needs of the profession, NHS England and the government must shoulder the responsibility and face the reality of years of failing to value, support and invest in general practice to ensure that GPs and their teams have the capacity to meet the growing needs of the population.

'This motion sounds a much-needed warning bell, rung by GPs at the end of their tether, emotionally and physically exhausted by the past 14 months. The onus is now on NHS England and ministers to fix a broken system so that patients as well as doctors have a GP service that is fit for purpose in every way.'

Commenting on the vote, Londonwide LMCs chief executive Dr Michelle Drage said: 'We are all at our wits' end. After general practice staff across London have shown our commitment to patient care throughout the pandemic - working at levels which well-exceed our full capacity, often making personal sacrifices for our patients’ safety at the cost of our own - it is outrageous to criticise our adaptability and agility.

'With the extraordinary level of demand practices are currently experiencing showing no sign of reducing, NHS England should be supporting and developing good general practice care for the benefit of patients, and our already exhausted and increasingly burned-out workforce - rather than continually sticking the boot in.'

An NHS spokesperson said: 'GPs have worked hard throughout the pandemic and are now pulling out all the stops to roll out the biggest and fastest vaccination programme in NHS history - providing vital protection to millions of people. NHS guidance, which makes sure that patients can access face-to-face appointments has been widely welcomed by patient groups and local health groups will now work with practices to make sure patients get services they need.'

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