Last month the BMA's GP committee voted unanimously to reject the government’s 'support package' and access plans for general practice, and to seek formal approval to ballot members on industrial action.
Independent analysis by the BMA found that 19 of the 29 measures proposed by the government in its rescue plan failed to offer new support to practices - and the association has warned the plans have left the viability of general practice in doubt this winter.
The BMA has now confirmed that a ballot of GPs will be completed by 14 November. It will determine the profession's views on actions that would see practices refusing to comply with ‘time-wasting’ parts of their contract, but with no impact on patient care.
The actions include:
- to disrupt appointment data collection which may be used for ‘naming and shaming’ GP practices,
- to not fulfil the contractual requirement to provide COVID-19 vaccination exemption certifications to patients who request it,
- disengaging from the PCN DES either outside of the opt-out period or during the next opt-out period, and
- not complying with the requirement from NHS England to submit GP earnings data as part of plans to name GPs and practice staff earning more than £150,000 in NHS income.
The decision to ballot members follows news last week that NHS England had agreed to make ‘significant concessions’ over conditions proposed in the GP access plans, including scrapping targets on face-to-face appointments.
GPonline has also learned that some integrated care system (ICS) leaders plan to ignore controversial directives for them to name and shame the 20% of GP surgeries in their area offering the lowest proportion of consultations face-to-face.
GP committee chair Dr Richard Vautrey said patient care was ‘suffering’ due to the government’s inability to address falling GP numbers and reduce workload pressure on practice teams.
He said: ‘It’s important to stress that these actions are not directed at patients, nor the care they receive, but absolutely at the government and NHS England, and in the interests of patient safety, they must act now to stop the abuse, reverse the unsustainable workload and address the burnout felt by so many GPs and their teams.
‘When you add to that the levels of bureaucracy we are expected to cope with, the time has come to say we cannot go on like this anymore. Yet the government and NHS England’s plan to solve this and support practices through the winter will make matters a lot worse.
‘The government's plan has simply added fuel to the fire in creating further bureaucracy and punitive measures for practices and demoralised the whole workforce. Doctors want to use their time to look after their patients, not to meet artificial targets and do even more paperwork.
‘Despite all attempts to work on a solution focused package backed by the profession, and to put in place a plan that really would improve access, quality of care, free up time by reducing bureaucratic workload and enable practices to properly care for their patients over this expected difficult winter, [the department’s] recent comments have only added to the anger and desperation felt by the general practice workforce across England.
A BMA survey of more than 6,000 GPs last month found that more than half (54%) would consider leaving the NHS if the government did not provide them with the support they needed during the pandemic. A further 66% said that they would reduce their current hours.
Last week the BMA encouraged practices to cease all non-GMS work and apply to close practice lists as a way to counteract the government's ‘bullying charter’ that it said failed to reduce workload pressures.
Despite pressure on general practice and criticism from some sections of the media, GP practice appointments rose in September to the highest total since five months before the COVID-19 pandemic, with face-to-face contacts accounting for a higher proportion than at any time since March 2020.
Launching the access plan and support package last month health and social care secretary Sajid Javid said the measures provided GP teams with 'investment and targeted support'. He said the plans would 'tackle underperformance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointments'.
He added: 'Alongside this we are setting out more measures to tackle abuse and harassment so staff at GP surgeries who work so tirelessly to care for patients can do so without having to fear for their safety.'