BMA GP Collective Action – Important information about changes in the Practice.
You may have noticed some changes in terms of services that we can/cannot deliver to some of our patients. Hopefully this article will help explain the reasons for this.
In August 2024, GPs voted to take ‘collective action’ to protest the limited increase, and overall decrease when inflation is taken into account, in funding for GP services in England, and the general pressures that GPs face. The British Medical Association (BMA) is the trade union and professional body for doctors in the UK. On 1 August 2024 the BMA’s committee of GPs voted to take collective action.
What is the BMA GP collective action?
As GPs are self-employed or employed by a practice (i.e. not by the NHS) therefore they cannot strike. GPs can however engage in ‘collective action’ guided by the BMA and Local Medical Committees. For this action, the BMA is suggesting that GPs ‘pick and choose’ from 10 options https://www.england.nhs.uk/long-read/collective-action-by-gps-supporting-guidance/
The actions chosen by Albany Surgery are listed further below.
Some of these actions can be permanent changes and an opportunity to embrace sustainable and safe change. Others may be de-escalated following negotiations with the new Government.
Why Collective action? Why now?
The aim of the collective action is to protect patients and protect practices to ensure they are around for many years to come. Over the last 10 plus years the amount of funding that Primary care receives has fallen significantly – 660million since 2018/2019- with general practice getting less than 7% of the overall NHS budget and spending and staffing numbers in hospitals ballooning. This is despite the population growing, people living longer with more chronic illnesses and the volume of work increasing.
We receive just £107.57 per year for each patient, whatever their health needs. That’s just 30p a day for every patient registered with us – less than the cost of an apple. More work has been moved out of the hospital to GPs without the necessary funding, with existing funding not being increased with inflation. Furthermore, there are large numbers of patients stuck on long hospital waiting lists waiting for assessment or intervention resulting in more GP activity and all whilst the number of full-time equivalent GPs and practice nurses have continued to fall, with increasing rates of burnout. The overall impact here is making accessing General practice services harder for patients, with staff working longer and harder to try and combat this and practices becoming more unstable.
Additionally, most GP surgeries are private businesses run by self-employed contractors (GP Partners) who hold NHS contracts to deliver GP and primary care services. Like other small business, GP surgeries have struggled since the pandemic with rising energy and utility costs, medical consumables, increasing staff wage costs, and lack of inflationary uplift for additional services undertaken by the practice making day to day running of surgeries challenging. This is leading to increasing numbers of GP surgeries closing for good (2000 have closed since 2010), making redundancies or not recruiting, which has led to the situation of understaffed surgeries not being able to afford to employ additional staff.
What does this mean for patients?
With less capacity in GP practices, patients might find they are directed to other services like NHS 111 (out of GP Practice opening hours) or your local walk-in centres more often. If you have a concern about your health, contact us via a SystmConnect or by phone as usual to book an appointment.
Albany Surgery are looking at the following key areas of change as per the 10 options provided by the BMA:
- Capping consultations / appointments to 25 per GP per day.
We are working towards capping the number of consultations (appointments/contacts) each GP carries out to the internationally recommended safe maximum of 25. We used to provide more but this is unsafe practice. This means that SystmConnects will be switched off when we are at our safe working capacity for the day (all SystmConnect requests triaged according to urgency and clinical need, and all appointment slots for the day have been taken). We will then signpost accordingly to other services such as Minor Injuries Units / Urgent Treatment Centres / 111 (only outside the Surgery opening hours) / Physiotherapy Services / A&E and so on. If your SystmConnect is not urgent you maybe asked to submit your SystmConnect again the following morning.
More information on the BMA safe working limits can be found here:
- Antipsychotic monitoring and prescribing, eating disorder monitoring/PSA monitoring/secondary care blood taking
We have served notice on physical health monitoring and prescribing of antipsychotics, physical health monitoring of eating disorder patients, PSA monitoring of patients not on PSA tracker. Medicolegally, this is specialist monitoring and prescribing that should safely be done by specialists, unless a detailed and agreed funded shared care pathway is in place.
We are also withdrawing from providing a blood taking service (blood tests) for the hospital. This is essential to ensure specialists are monitoring specialist blood tests accurately and safely. It is also a cost-analysis. The amount we are paid to deliver this service is approximately £1 per patient. As you can imagine this does not even cover equipment, let alone staff time in taking blood and interpreting results.
See communication for patients regarding the blood tests change.
See communication for patients regarding Antipsychotic and Eating Disorders.
- Post bariatric surgery monitoring and prescribing
We are also looking to serve notice on the prescribing and monitoring of patient’s post-bariatric surgery, this should be done by the hospital team carrying out the surgery in the first 2 years post surgery and then via a shared care agreement if one exists, if not the hospital will need to continue monitoring. For patients considering seeking this or other operations privately or abroad, please be aware that your monitoring (bloods etc) and prescribing will need to continue privately as there are no shared care agreements with private providers in the UK or abroad.
- Other ‘handing back’ activity.
We will also be handing work back to hospitals and other community staff that should be done by them as part of the hospital contract for example (this is not an exhaustive list):
- Issuing of Med 3 sick notes when needed at outpatient appointments/admissions.
- Ensuring when medication is suggested at an appointment or admission that the hospital issue 14-28 days’ worth of this.
- Ensure that when bloods, imaging or other investigations are carried out in hospital that the requesting hospital clinician follow up these results.
- When further investigations or onward referrals are needed as a result of a hospital assessment that the hospital action these and so on.
We would like to say that taking collective action is not about penalising patients, and it is not a decision any GP practice has taken lightly. We are taking action because the future of General Practice as we know it is at stake. GPs are on your side, we know that things like continuity improves health outcomes, so we are striving to achieve a reset and more funding and staffing to hold onto these elements. The actions are designed to do the right thing for General Practice and it’s patients.
If you would like to support the practice, please get in touch with the Patient Participation Group chair – Mr David Vizard.
