GPs vote to take collective action for first time in 60 years

Family doctors across England have voted overwhelmingly in favour of taking collective action for the first time in 60 years in a row over their new contract.

They will be able to choose from a series of actions set out by the British Medical Association (BMA) after 98.3% of more than 8,500 GPs who took part voted in favour.

Doctors have said the action could last for "months" and could bring the NHS to a "standstill very quickly" for NHS administration staff and politicians but not for patients.

The options include:

• Limiting daily patients to 25 - about a third fewer than normal
• Stop engaging with the e-referral and guidance service, which allows GPs to seek advice from other clinicians
• Switching off NHS software that allows discounted or free prescriptions for some people
• Referring patients directly to specialist care rather than following more complex NHS processes
• Refusing to share patient data unless it is in the best interests of a patient
• Withdraw permission for data sharing agreements that use data for secondary purposes
• Defer making any decisions to accept NHS pilot programmes.

Each GP practice will pick and choose which one to implement, as they see fit.

They could start with one and add more incrementally or could do all of them from day one.

Many of the actions will lead to GPs spending more time with their patients, while showing how problems are generated by "NHS wider systems, national mismanagement and bureaucracy", the BMA said.

The new GP contract, which will see services given a 1.9% funding increase for 2024/25, means many surgeries will struggle to stay financially viable, according to the BMA.

The last time GPs took collective action was in 1964 when family doctors handed in undated resignations to the Wilson government.

This led to reform including the Family Doctor Charter of 1965, which delivered major changes in the way GPs are paid.

Fresh from settling the junior doctors’ strikes Wes Streeting must do the same for GPs

Fresh from resolving the long-running junior doctors' strikes, Wes Streeting must now do the same with GPs.

He is right to say that this is not a mess created by the new government, but it is his inheritance.

And he will need to resolve it as quickly as possible.

While it's not a strike in the same way, as GPs have legally abiding contracts, it does mean practices across England can make individual calls on what sort of action they will take and this will invariably impact patients.

The guidance from the BMA is a limit of 25 patients per day for each GP.

This is the recommended safe maximum but many GPs routinely see more than this.

NHSE is keen to stress doctors' surgeries are still open and patients should still try to get an appointment with their GP if they feel unwell.

But in reality it means patients - many of whom already complain about not being able to see their GPs when they want to - will attend hospital instead.

And that's exactly what health leaders do not want.

It also means Wes Streeting may have to delay his plans for making community care the focus of his remodelling of the healthcare system.

The intention is to work harder at prevention, early intervention and treatment away from an acute setting. To deliver this he needs his GPs on board.

The new health secretary has told family doctors their beef is with the previous administration and his government is committed to reforming the NHS for the benefits of patients and its staff.

The problem now is that he is likely to face unions representing health workers who will feel that they can hold out for better pay and conditions after the junior doctors settlement.

Health Secretary Wes Streeting said: "We inherited an absurd situation, where patients can't get a GP appointment, and GPs can't get a job.

"We're taking immediate action to recruit an extra 1,000 GPs. I want to work with GPs to rebuild the NHS together."

Dr Katie Bramall-Stainer, chair of the BMA's GP committee for England, said: "This will not be a 'big bang', it will be a slow burn. It's likely that impact may not be felt for some time.

"We hope this will give the new government time to consider our proposed solutions including fixing our contract once and for all."

Dr Bramall-Stainer said GPs were "at the end of their tether" and "for too long, we've been unable to provide the care we want to".

"The era of the family doctor has been wiped out by recent consecutive governments and our patients are suffering as a result."

She said there have been "countless opportunities" to address funding issues in general practice and although nearly all GPs voted to reject their 2024/25 contract offer, "nothing was done".

She said GPs understand the new Labour government has inherited "a broken NHS" and the BMA has had "some positive conversations" with Mr Streeting but the causes behind practices closing and GPs leaving remain.

Dr Brammal-Stainer also said the collection action "will help keep practices open and keep GPs in the NHS workforce to buy time for Mr Streeting to make the necessary changes that were promised in the Labour Party's election manifesto".

Conservative shadow health secretary Victoria Atkins said: "After appeasing junior doctors with a budget-busting 22% pay rise, it comes as no surprise that other healthcare workers are feeling shortchanged by the new Labour government.

"Instead of caving in to unaffordable union demands, the Labour government must resolve this dispute or it is patients and the public who will pay the price with more strikes and higher taxes."

The action comes after the Department of Health and Social Care made a new pay offer to junior doctors in England - potentially bringing months of strike action to an end.

Junior doctor members of the BMA are now voting on whether to accept the deal, which is worth 22.3% on average over two years.

-SKY NEWS