GP leaders have voted to ballot on potential collective action in England.[1]

The ballot will be open to GP contractors/partners and, if there is a majority vote, then doctors will be able to take action immediately; the BMA will not direct GPs to breach their contracts in this initial phase.[2]

Collective action can include limiting the number of patient appointments per GP per day to the recognised safe working maximum level of 25 – something the BMA has been highlighting since 2016.

It can also mean GPs will stop or reduce work that they’re not formally contracted to do, but, because of pressures elsewhere in the NHS, has been passed onto them, without any additional resource. This is on top of not having enough funding to carry out their own essential care services.

This could include the completion of fit notes, prescriptions or investigations which should have taken place in the hospital setting, or asking Trusts to communicate with patients about re-booking hospital appointments.  

The decision to launch the ballot came at a meeting of the BMA’s England GP Committee (GPCE) today, after the organisation entered into a dispute with NHS England over the 24/25 GMS contract changes.[3]

At a time of rising running costs and staffing expenses, the changes saw a funding uplift of just 1.9% for general practice from April, which could force surgeries, already struggling financially and on the brink of closure, to shut their doors for good before autumn 2024. The BMA is already aware of practices across the country having taken the decision to close since the April contract was imposed.

The contract also does nothing to make it easier for practices to afford to hire more GPs and practice nurses, further depriving communities of the care they need. 

In March, the BMA asked members in a referendum whether they accepted the changes to the 2024/25 contract. More than 19,000 GPs took part and almost 100% voted ‘no’. 

Despite these warnings, the Government has so far failed to make any improvements to the contract, prompting the committee to launch a ballot on collective action.  

Although the Government has said it will honour the Doctors' and Dentists' Pay Review Body (DDRB) 2024 uplift award, there is little faith from the profession that it will be enough - or done in time to save many surgeries from closure. 

The ballot will open on 17th June and close on 29th July.

Dr Katie Bramall-Stainer, chair of GPC England at the BMA, said: “We’ve been warning the Government for some time now that without drastic improvements to the GMS contract, GPs will be forced to consider taking action. 

“The care GPs want to provide, and the services patients want to receive are the same. GP services have been eroded to the tune of hundreds of millions of pounds in recent years, with over a thousand practices lost across England. There is funding but practices are forbidden from using it to hire more GPs and more practice nurses, which is just crazy given the patient experience in trying to see their family doctor. For many surgeries the numbers don’t add up and with rising running costs it is impossible to stay open at all.

“Today should act as a wake-up call to Government that GPs are ready to stand and fight to protect their practices and patients. 

“Ministers can stop any further escalation, but until they sit down and take our concerns seriously, we have no choice but to urge members to vote ‘yes’ in this ballot and take action to save general practice.” 

Notes to editors

1. This is a non-statutory ballot, meaning any action(s) the BMA subsequently directs GP contractors/partners and their staff to take will not involve contract breaches. A statutory ballot is therefore not required at this stage, but the BMA has opted to proceed with an online non-statutory ballot. Collective action is the term we are choosing to use.

2. This is the first phase. The committee hopes any subsequent phase where action may escalate, will not be necessary and stands ready to discuss and agree the contractual improvements needed in 2024/25 to restore general practice to 2018/19 funding levels.

3. The committee voted in favour of the following motion:

Following the overwhelmingly positive profession wide referendum result in March 2024, GPC England affirms its commitment to proceed with plans for a non-statutory ballot, inviting GP contract-holding members of the BMA to vote in favour of taking part in collective action to protect their practices and protect their patients.

Proposer: Dr Katie Bramall-Stainer (chair)

Seconder: Dr Samira Anane (deputy chair)

• Number who voted for: 57

• Number who voted against: 0

• Number who abstained: 1

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

For media enquiries please email [email protected] or call 020 7383 6448