More than half of GP practices prepared to pull out of PCNs, BMA ballot shows

More than half of GP practices in England are prepared to opt out of the PCN DES - and many more are ready to defy rules around pay transparency and other elements of bureaucracy, a BMA indicative ballot shows.

Sign outside BMA House

Findings from the ballot - revealed as part of new BMA GP committee chair for England Dr Farah Jameel's first speech in the role - show that well over half of GP practices are willing to drop out of PCNs at the next opt-out window.

Findings from the indicative ballot - based on responses from around 1,700 GP practices over a two-week period, show: 

  • 84% are willing to refuse to comply with requests for COVID-19 vaccination exemption certificates
  • 80% are prepared to participate in a co-ordinated and continuous change to their appointment book
  • 58% are prepared to withdraw from the PCN DES at the next opt-out period
  • 39% are prepared to disengage from the PCN DES outside of the next opt-out period
  • 87% are prepared to refuse to comply with a contractual requirement for GPs to declare their income if it is over £150,000

BMA ballot

BMA leaders announced the ballot in the wake of the controversial access plan and support package for general practice announced last month by NHS England and the government.

Billed as a policy change that would offer support to general practice, GP leaders said that instead measures set out by the government threatened to further intensify workload for practices.

Part of the controversial measures suggested practices would be 'named and shamed' over levels of appointments delivered face-to-face - and set out plans for integrated care systems to identify and intervene at up to a fifth of practices delivering lower proportions of patient contacts in person.

GP committee chair Dr Jameel told LMCs: 'Today, we draw a line in the sand. Enough is enough. We took the decision to survey the profession in the face of such extreme difficulty.

GP anger

'We carried out an indicative ballot which gave one vote to each practice with a GP partner who is a BMA member. The window for this process gave practices a mere two weeks to respond and yet, we achieved a turnout of 35%. At face value, it may not sound like much, but let me tell you, to achieve this response rate in such a short space of time speaks volumes about the strength of feeling across the profession.'

She said the results 'showed that GPs and practice staff are frustrated, struggling and are desperate to see change', calling the findings 'an overwhelming expression of sentiment, a sentiment of discontent and disappointment'.

Dr Jameel added: 'Make no mistake. This is a profession on its knees, and continuing to fight for its existence. This hasn’t come out of the blue and this should not be a surprise to anybody, not least those in Whitehall.

'At the beginning of this pandemic, general practice was under-resourced and unprepared for any surge in demand. We knew that the 5,000 extra GPs promised to us in 2015 were not coming, in fact we now have 1,700 fewer full-time equivalent, fully trained GPs since then.

'A decade of austerity left us feeling the strain and working at the limits of our capacity and our sanity. We have repeatedly warned those who hold so much sway over our working lives and the fortunes of the NHS that we were struggling.'

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