Could a National Association of LMCs shake up GP leadership?

GPs at the UK LMCs conference next month will debate plans for a National Association of LMCs amid growing discontent over how the profession is led that could see the BMA stripped of funding and control over general practice.

BMA House entrance

LMC representatives meeting in York on 10 and 11 May will take part in a themed debate on the formation of a National Association of LMCs.

The conference agenda says that 'a lack of clarity' remains around the issue - and that the debate will seek views from LMC representatives on what a National Association of LMCs is, how it would work and what its remit could be, what alternatives may exist and how widely supported the idea may be.

Although it may be unclear at this stage how the association could work, it is clear that discontent with the leadership of general practice is the key factor driving the plans.

GP leadership

A string of motions submitted by LMCs described in the agenda as 'best covered by this themed debate' are heavily critical of the BMA's GP committee and its representation of the profession.

The motions show LMCs - which represent grassroots GPs across the country - are giving serious consideration to a move to strip funding and control over GP contract negotiations from the BMA's GP committee.

Motions suggest that discontent cuts across a broad sweep of the profession - reflecting concerns that partners and the independent contractor model are not adequately represented; and that at the same time the BMA is 'irreversibly conflicted' and cannot 'adequately support both sessional and contractor GPs under one organisation'.

A North Staffordshire LMC motion says the 'current form of national representation of GPs requires review' and calls for a review of 'the record of the GPC in representing the GP partnership model in annual negotiations'.

Partnership model

An Avon LMC motion says the GP committee is 'not serving the partnership model of general practice' and demands a 'separate union' developed through LMCs to represent GP partners.

A West Sussex LMC motion says the BMA GP committee is 'not demonstrating that it is a functional representative body of GPs'.

More than one motion demands the BMA GP committee is either stripped of funding that comes from LMCs via the levy paid to the GP Defence Fund (GPDF), or that this funding is reviewed.

A motion put forward by Cambridgeshire LMC, meanwhile, suggests that a review by former BMA chair Dr Hamish Meldrum that led to changes in how the association operates 'directly led to a decline in effectiveness of some GPC committees, and directly led to changes in the BMA/GPC relationship which further endanger the future of general practice'.

GMS contract

It also calls on the GPDF to investigate 'what other avenues of possibility there are to negotiate future national contracts outside of the BMA'.

The debate marks the latest challenge for the BMA's GP leadership after high-profile criticism over the past year and in the wake of contract changes imposed for 2022/23 by NHS England.

GPonline reported this month on a draft letter from LMCs to the GP committee that called for stronger action to stop the 'slow death' of the contractor model of general practice.

The BMA GP committee faced the resignation of two senior figures from policy roles last year after it returned to talks with NHS England in the wake of a no confidence vote in the health service leadership over comments around face-to-face appointments.

The committee has faced further criticism after NHS England imposed contract changes that the BMA says could pose a risk to patient and staff safety - and has faced questions over its decision not to move to a formal ballot on industrial action after an indicative poll showed more than half of practices would be prepared to opt out of PCNs.

The groundwork has been laid for the creation of a National Association of LMCs - with a company by that name set up last year by the leaders of the GPDF following a debate at last year's UK LMCs conference.

In comments to GPonline earlier this month, BMA GP committee deputy chair Dr Kieran Sharrock called for the profession to 'pull together' at a time when a declining workforce is facing unprecedented workload pressure.

He said the GP committee was committed to the independent contractor model, adding: 'The profession can rest assured that GPC England offers the strongest possible support for the independent contractor model as the cornerstone of general practice. The voices of grassroots GPs will be instrumental in how we move forward.'

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