In an update to members, BMA GP committee chair Dr Richard Vautrey encouraged surgeries to ‘take actions that prioritise a higher quality of care’ and deliver a safer service for both patients and the workforce.
He said that GPs should ‘not feel pressured to return to a traditional 10-minute treadmill of face-to-face consultations that are neither good for patients nor clinicians' and backed offering consultations that are 15-minutes or more.
The BMA said it would be providing more advice in the coming days on 'what practice could do if NHS England and the government fail to take the action needed to properly support general practice.'
However the update to members suggested that practices should 'apply to close the practice list to focus on the needs of existing patients' and stop all non-GMS work to give priority to core contract services.
Reject secondary care work
The BMA also recommended that practices should reject all work that has been 'shifted' from secondary care, unless it has been properly commissioned, refuse to accept additional NHS 111 referrals above the contracted 1 per 3,000 patients and stop 'unnecessary' cost-based prescribing audits to focus on quality care.
Practices are also advised to decline to take on additional extended access sessions in order to focus on core work.
The update comes after the BMA GP committee last week voted unanimously to reject the government's 'support package' and access plans for general practice.
The BMA has recommended that practices should 'not comply' with the proposals, which it says would involve them having to spend more time on bureaucratic processes.
The GP committee is now seeking formal approval from the BMA council to ballot members on industrial action. This could be in the form of a boycott of pay transparency rules and participation in the COVID medical exemption certification process.
The committee also backed a call for LMCs to collect 'undated resignations' from the PCN DES, that could be handed in if 'submissions by a critical mass of more than 50% of eligible practices is received'.
General practice crisis
In the latest update to practices Dr Vautrey says that the BMA believes health and social care secretary Sajid Javid 'ignored GPs' expertise and experience when he laid out his bully’s charter and patient care will suffer as a result'.
He added: 'We are now calling on the government to withdraw their plan and work with us to introduce a new contract that ensures general practice is properly funded with a safer workload and reduced bureaucracy, and ultimately provides better care and services for patients and vastly improved working conditions for doctors and their teams.'
The BMA has encouraged practices to review its 2018 guidance on workload control in order to help them establish safe limits within which to work. The guidance suggests GPs can safely conduct 25 routine appointments per day, or around 17 complex consultations.
The union has previously warned that the viability of general practice this winter is in doubt because the vast majority of measures in the government's 'support package' offer no new help to the profession. Its analysis found that 19 of the 29 measures fail to support at all, or simply re-state existing policy.
Three have the 'potential to offer support, but not immediately', while the remaining seven offer only limited support that would be far outweighed by the 'punitive approach that is being pursued', the analysis warned.
GPonline analysis of RCGP data shows that GP workload intensified sharply in the final two weeks of September, with practices delivering 6% more consultations and a third more clinical administrative work than in the same period in 2019.