GP REFERENDUM
NATIONAL
Protect Your Patients, Protect Your Practice - Vote YES and use the BMA GP Practice Survival Toolkit
The ballot to Save General Practice is open. Following the third annual contract imposition and with general practice at crisis point, we are holding a non-statutory ballot of GP Partners. Funding for core general practice services has been severely eroded. We’ve lost over 10,000 GPs and over 1,300 practices in a decade while patient numbers increase, and patient dissatisfaction sadly rises.
In the referendum earlier this year almost all of you said a firm NO to the new contract - you were ignored by the Government who have refused to make any improvements or give general practice any more resources.
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Vote YES to keep the pressure up. Vote YES to protect your practice and to protect your patients. Vote YES to save general practice. |
How to take part in the ballot
The ballot is open to all GP contractors and partners in England and will close on 29 July (to vote you must be a member of the BMA). You should have received an email from bma@cesvotes.com - your link to vote is unique and should not be forwarded as it can only be used once. Support for GP members in England who can’t find or didn’t receive a voting email
If you have any questions, please email: gpcontract@bma.org.uk
Read our GP campaign page for more information about the ballot, contract guidance, and how to order campaign materials such as BMA GP Practice Survival Toolkit cards which fit inside GPs Are On Your Side lanyards, badges, window stickers, and patient leaflets. All can be ordered directly from the BMA Reps Hub or via the GP campaign page.
Register for the online roadshows across the country and the online webinars here
BMA GP Practice Survival Toolkit
We will be inviting GP Partners to work with their practice teams and, in liaison with their LMC, to determine the actions they will be willing to take. Each of these actions is outlined in the BMA GP Practice Survival Toolkit
It is for each practice to pick and choose as they see fit. You may decide to add to your choices over the days, weeks, and months ahead. This is a marathon, not a sprint. You can read more about these actions in the guidance provided or in our FAQs.
Read also our 2024/25 contract guidance documents, which now also includes an ‘Advice and Guidance update’, to help you consider how best to approach the contract changes.
GP practice survival toolkit
Below are nine actions for practices to choose from. The actions you choose may depend on your patients, your local contracts and your LMC’s feedback. You can choose to start slowly and build incrementally or do all of them from day one as you wish. You do not need permission to do any of these actions. They are already permissible and will not result in contract breach.
- Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25 .Divert patients to local urgent care settings once daily maximum capacity has been reached.
- Stop engaging with the e-Referral Advice & Guidance pathway - unless it is a timely and clinically helpful process for you in your professional role.
- Stop supporting the system at the expense of your business and staff - serve notice on any voluntary services currently undertaken that plug local commissioning gaps.
- Stop rationing referrals, investigations, and admissions
- Refer, investigate or admit your patient for specialist care when it is clinically appropriate to do so.
- Refer via eRS for two week wait (2WW) appointments, but outside of that write a professional referral letter where this is preferable. It is not contractual to use a local referral form/proforma – quote our guidance and sample wording
5. Switch off GPConnect functionality to permit the entry of coding into the GP clinical record by third-party providers.
6. Withdraw permission for data sharing agreements which exclusively use data for secondary purposes (i.e. not direct care). Read our guidance on GP data sharing and GP data controllership.
7. Freeze sign-up to any new data sharing agreements or local system data sharing platforms. Read our guidance on GP data sharing and GP data controllership.
8. Switch off Medicines Optimisation Software embedded by the local ICB for the purposes of system financial savings and/or rationing, rather than the clinical benefit of your patients.
9. Practices should defer signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance.
- Defer signing off”Better digital telephony”: do not agree yet to share your call volume data metrics with NHS England.
- Defer signing off “Simpler online requests”: do not agree yet to keep your online triage tools on throughout core practice opening hours, even when you have reached your maximum safe capacity. - Read our guidance on this.
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We’ve produced a range of materials to help you engage patients in the campaign GPs Are On Your Side: |
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The GPsOnYourSide Campaign page can be shared with patients and the public.
GPC England ballot for GP contractors / partners – Protect Your Patients, Protect Your Practice
Vote YES and use the BMA GP Practice Survival Toolkit
It is now only three days to go until 17 June when the ballot to Save General Practice opens. We are holding this non-statutory ballot because general practice has been deliberately broken. Over 1,300 practices have been lost, and thousands more GPs with them. Funding for essential practice services has eroded to the tune of £660 million and successive sub-inflationary uplifts have threatened practices’ viability. With almost 2000 fewer FTE GPs compared with a decade ago, and an additional 6.4million patients it is no surprise that patient dissatisfaction has doubled in the past five years.
In the referendum earlier this year almost every single one of you said a firm NO to the new contract and you were ignored by the Government, who have refused to make any improvements or give general practice any more resources.
This ballot is open to all GP contractors and partners in England. If you’re not yet a member you can join the BMA now to ensure you have your vote. And what’s more, any new member joining from 17 June, will get their first 3 months of membership for free: www.bma.org.uk/join
The Ballot Question:
‘Are you prepared to undertake one or more examples of collective action as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice?’
The Ballot Answer
Vote YES to Take Action to Save General Practice.
Vote YES to protect your practice and to protect your patients.
We are not asking you to breach your contact, but we are asking you to take a stand.
The ballot opens 17 June and closes on 29 July ahead of action commencing from Thursday 1 August
Read our GP campaign page for more information about the ballot, contract guidance, and how to order campaign materials: www.bma.org.uk/gpcontract
What will the menu of actions look like?
We will be inviting GP Partners to work with their practice management team and, working in liaison with their LMC, determine the actions they will be willing to take. Each of these actions is outlined in the BMA GP Practice Survival Toolkit
It is for each practice to pick and choose as they see fit. You may decide to add to your choices over the days, weeks, and months ahead. This is a marathon, not a sprint.
PCN DES 2024/25 GPC England Guidance on the Capacity and Access Improvement Payment (CAIP)
There are three separate and discrete elements to the CAIP within the 24/25 PCN DES:
- Faster care navigation, assessment, and response
- Better digital telephony
- Simpler online requests
GPC England guidance is that practices should defer signing declarations of completion for “better digital telephony” and “simpler online requests” until further GPC England guidance in early 2025.
Read our Focus on guidance
GPC England recommends PCNs do not confirm compliance with the on-line platform CAIP element at this time, because unless the workload associated with a practice’s on-line platform can be controlled, it will not be possible for practices to effectively implement the BMA Safe Working Guidance.
GPC England recommends PCNs do not confirm compliance with better digital telephony CAIP element at this time as NHS England has signalled its intention to issue a contract variation notice from October 2024 to make the sharing of the eight call data metrics they have identified contractual.
GP Contract guidance and campaign materials
We have now published our 2024/25 contract guidance documents, to help you consider how best to approach the contract changes. These documents cover the following areas:
- Dispensing and prescribing
- GP data sharing and controllership
- Limited Liability Partnerships and the GMS contract
- Medical Associate Professions in General Practice
- 2024 Premises Cost Directions
- Use of enhanced access appointments
- Vaccinations and Immunisations
- Proformas and referral forms
- Spending and the PCN DES capacity and access payment funding
We have also produced campaign infographics for you to attach to your emails, practice website and socials, as well as PPG and patient-facing resources – all of which are available to download from the BMA website or to be ordered directly BMA Reps Hub.
See the GP campaign page for more information about the ballot and how to order materials.
The GPsOnYourSide Campaign page is for practices to share, should you wish, with patients.
BMA.org.uk/GPsOnYourSide Public-facing campaign
We have produced campaign posters, presentation slides and infographics for you to attach to your emails, practice website and socials, as well as PPG and other patient-facing resources – all of which are available to download from the BMA website
The GPsOnYourSide Campaign page is ready for practices to share with patients and the public.
Campaign materials for GPs and practice teams
GP Survival Toolkit cards to fit inside GPs Are On Your Side lanyards, window stickers, posters, badges and leaflets are now able to be ordered directly from the BMA Reps Hub.
See the GP campaign page for more information about the ballot and how to order materials.
GPC England Officer Team face-to-face contract roadshows
The GPC England officer team are currently travelling the country in a series of over 20 roadshows, hosted by regional LMCs. This is an opportunity to hear face-to-face about the action practices will be able to take, details about the ballot, expert leading counsel advice, collection of your practice resources, and a chance to discuss and debate with your peers.
The roadshow events are taking place across England from now until 24 July and are open to all GP contractors/partners and practice managers, salaried GPs, GP registrars and practice nurses. You do not need to be a BMA member to attend, so please invite your colleagues and ensure there is representation from every practice in your locality.
There are also a number of virtual webinars, which will be open to all.
See the list of events across the country and register here
BMA membership details
It is vital that you keep your BMA membership details up to date so you can vote in our ballot. To vote, we need you to login to www.bma.org.uk and check your details are current and correct. We must have the right information for your vote to count, so please check.
Please look out for an email from bma@cesvotes.com which will allow you to vote.
We need:
- Your personal details, including a valid email address
- Place of work details for all your roles
Your details MUST be up to date for your vote to count.
In this first ballot, GP contractors / partners need to vote YES to send a message to Government that we are ready to stand up for a better service for our patients, and to protect our practices.
Please check and update your details here BMA - Sign In
Non-members still have time to join in the ballot. Any new member joining from 17 June, will get their first 3 months of membership for free. The latest date to join for the vote to be counted is 22 July. Please encourage your colleagues to join: bma.org.uk/join
OFFICIAL GPCE INFO: LMC update 3 April 2024
On behalf of GPC England, I want to thank every single GP and GP registrar across the country who took part in our referendum. Let us not forget, this referendum wasn’t even a ballot, it was merely a dress rehearsal for what’s around the corner. Either way, had it been a ballot, it would have comfortably passed the required thresholds.
This referendum was a temperature check of the profession - and make no mistake - in the week where we have a third consecutive contract imposition, we are at boiling point. I’m overwhelmed to share the result that more than 99.2% of you have voted firmly against this contract. This is an unequivocal result that will demand NHS England, the Department of Health and Social Care, Government, and other parties now sit up and take notice.
It is now clear that we are one profession, which has spoken with one voice and said enough - time’s up. This contract imposition does not give practices stability. It does not give us hope. This contract, which NHSE are choosing to impose upon us, is not safe.
The contract changes, which will be imposed by the Government and NHS England from 1 April 2024, include a national practice contract baseline funding uplift of just £179m for England’s general practices, way below inflation in recent years, meaning many practices will struggle to stay financially viable over the next six to 12 months and risk closure.
The day after the referendum closed, GPC England met to decide and determine the next steps we’ll be taking as a profession knowing you’re standing right behind us. We are now starting to receive the full dataset and results breakdown from Civica, and we’ll share that with you in due course too.
When I qualified as a GP in 2008, we were called the ‘jewel in the crown of the NHS’. General practice has been demeaned, diminished, diluted, bullied and gaslit long enough. We now start the fight back, bringing our patients with us. Patients want access to their family doctor in a surgery that feels safe, with a well-resourced team ready to meet the needs of our communities, and that’s what we want too.
We are the bedrock upon which the rest of the NHS stands, with 400 million patient contacts a year. Almost 1.4 million every single day. That’s a lot of voters.
So congratulations, ‘team GP’. The battle to save general practice has begun. I’m proud to represent you, and I know that your BMA committee, GPC England, is proud to serve you.
We will be in touch soon with more information, guidance on the 2024/25 contract and next steps for us all.
- Watch my video about the GP contract referendum results: GPCE contract referendum results
- Find out about the contract changes and read our FAQs to learn what this means for you.
- Link to press release: GPs vote overwhelmingly to reject contract changes in BMA referendum
OFFICIAL GPCE INFO: LMC update 9 February
Referendum and next steps
We have produced a webpage with everything you need to know about the current GP contract changes and what we plan to do next. Remember, whatever is on the table come March 1st will be put to you in a referendum which will enable the profession to decide whether the offer sufficiently supports general practice in England for the forthcoming financial year, or not. to decide whether the suggested changes sufficiently support general practice in England for the forthcoming financial year, or not.
To be eligible to vote in the referendum, you need to be a member of the BMA to have your say. This means making sure your details are up to date and spreading the word to colleagues about joining the BMA. The referendum won’t prevent the Government from imposing changes to the contract, but it will give us vital insight into how the profession feels, and where we go next.
Update your member details on www.bma.org.uk/my-bma and share this email with your colleagues and encourage them to join the BMA today to have your say. Visit our GP contract page here
LOCAL
April 2024 update: GMS CONTRACT FOR 2024-25 / ROadshows and onwards.
Following the 98.2% rejection of the imposed GMS contract for 2024/25 by GPs, the BMA has now contacted NHS England to advise that the profession is now in formal dispute.
There will now follow a period of discussion and developing the final plans for Industrial Action which is planned to happen late November to early December 2024.
The GPC is arranging 10 Roadshows across England. The most convenient for most GPs in LLR will be Coventry on 11 June 2024. Once the venue has been finalised we will circulate how to sign up to it.
The full proposed timetable (please note the dates are subject to change) is:
May 2024
2 May: local council elections 2 May.
16 May: Vision document to be published at GPCE meeting.
24-25 May: UK Conference LMCs with GPCE/LMC roadshow dates announced for the 10 England regions.
June 2024
Political party manifestos likely to be published.
GPCE/LMC roadshows across the 10 England regions commence (dates TBC).
BMA to undertake focus groups on GP industrial action with public and profession to complement the roadshows in England.
24-25 June: BMA Annual Representative Meeting.
July 2024
GPCE request permission from BMA UK Council to approve option for prospective IA. GPCE will meet face to face to deliberate strategic timeline and plan for Autumn action (if required).
Doctors and Dentists Remuneration Board (DDRB).
August
Allow time for negotiations in light of DDRB discussions to prepare communications tools and resources for use in September.
September
BMA membership push from the very start of the month, with a view to open the IA ballot by early September (if required) to coincide with political party conferences.
October 2024
Potential GP IA across England announced and enacted timed to commence alongside likely announcement of a late November/early December general election when UK enters period of pre-election sensitivity “purdah”. This period effectively silences the Department of Health and Social Care/NHS England Mandate expected for the for 2025/26 Contract negotiations.
November 2024
US Presidential elections.
UK general election campaigns with ongoing GP collective action likely coming up as a doorstep issue.
December
Likely general election.
Ongoing GP collective action.
January 2025
31 January: final date for a GE under current legislation.
Likely negotiations begin with new Government and new Health Secretary and Ministers. Whatever the shape of that new Government, the GPCE team will require a mandate and evidence of collective action to meet to negotiate the most favourable and successful outcome.
The BMA has written to all ICBs asking them to add industrial action to their risk registers. We have raised this with the LLR ICB who are still deciding how to rate the risk.
The LMC office has received many queries asking about what form the industrial action will be. This is still being explored, but I suspect that the final details will not be shared until GPs are formally balloted. Please remember that in order to participate in the ballot you will need to be a member of the BMA.
Please remember that practices do not need to wait for industrial action before implement safe working, or ensuring that they are not unknowingly providing services they are not contracted or funded to provide.
Rebuild General Practice is offering a free masterclass on Digital Campaigning. Full details as below.
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LMC Update - April 2024
GMS CONTRACT FOR 2024-25 / REFERENDUM / NEXT STEPS.
Many of you will have heard Dr Katie Bramall-Stainer talking about the current situation at our Annual General Meeting on Thursday 21st March 2024, or at one of the GPC Webinars.
The GPC referendum was a fore runner to a possible ballot on industrial action. The final result was that 19,009 GPs voted, representing a turnout of 61.2% of those who had been sent a voting paper. Only 155 voted in favour of the proposed contract for 2024-25 meaning that 99.2% of GPs rejected it.
One of the issues that the referendum highlighted was multiple problems within the BMA database of GP members. If you or anyone that you know is a BMA member but was not able to vote, please contact the BMA or the LMC office, to ensure that this is sorted out before the ballot regarding industrial action.
The next step is that the GPC will hold regional meetings to discuss with as many GPs as possible your views, what action you would be willing to take, and what you hope the BMA can achieve. We will share further information in due course.
NHS England continue to be either blase or uncaring about the actual state of general practice as seen in their most recent letter. They continue to be obsessed with quick and easy access to general practice regardless of the effect that this narrow approach is having on quality of care, including continuity of care. In addition, the evidence from the national patient survey is that this is also not what they value the most. As can be seen from this infographic produced by Beds and Hart LMC, there is no correlation between number of appointments and patient satisfaction:
However, there is correlation between patient satisfaction and being given enough time with the clinician.
The LMC continues to advise all GPs to join the BMA at least in the short term so you can participate in the most important debate about the future of general practice, including voting in the unavoidable. We ask all GPs to join our WhatsApp group to get timely updates, and also please ensure that every GP you know is on the LMC distribution list (i.e. did you receive this newsletter directly, if not please let us know).