Motions submitted by LMCs for debate at the conference reflect the extent of the crisis facing general practice, with warnings about workload, the impact of new care models, underfunding and indemnity costs among themes set to dominate.
But a motion put forward by Bedfordshire LMC reveals the extent of GP anger in parts of the country. The motion says: 'Given that a number of GPs genuinely feel that they can no longer operate within the NHS, conference calls on GPC England to urgently look at how these GPs can be supported to operate within a private, alternative model.'
GP leaders have repeatedly rejected calls for patients to be charged a fee when they attend an appointments with an NHS GP, but backed a motion at the UK LMCs conference earlier this year calling on the GPC to 'produce a discussion paper outlining alternative funding options for general practice, including co-payments'.
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Proposals to develop a private model of general practice, however, would go far beyond the introduction of fees. The idea has echoes of the 'plan B' developed in Northern Ireland for GPs to quit the NHS and work in a Republic of Ireland-style private system if a potential mass resignation goes ahead.
GP leaders will warn at the conference in London next week that no GP should work for longer than 12 hours in a single day. LMCs have previously called for a cap on practice workload, and will now demand guidance 'to support GPs to limit their working day to ensure patient safety'.
A motion listed for debate warns that 'tired doctors are potentially unsafe doctors' and that GPs should be helped to refuse unmanageable work without feeling guilty.
Patient demand
GP leaders will also call for new powers for practices to refuse or delay new registrations from patients who have not changed address, for dispersal of practice lists to be managed in collaboration with LMCs and for funding to support practices taking on patients dispersed from closing practices to receive funding faster.
The GPC will be asked to 'publicly dissociate itself from the GP Forward View' - NHS England's plan that promised an extra £2.4bn per year for general practice by 2020/21 - unless it can negotiate mechanisms for the extra money to reach practices 'directly without additional nureaucracy or additional workload requirements'.
GP leaders will also hit out at rising indemnity costs, with the government expected to be at least 18 months from delivering the 'state-backed' indemnity scheme announced by health secretary Jeremy Hunt at the RCGP conference.