GP partners across England had been taking part in collective action to stay safe and sustainable. While the 2025/26 GP contract agreement ended GPCE's national dispute with the Government, action remains crucial to address persistent commissioning gaps and renegotiate these pathways locally. Practices should be appropriately resourced for the work they undertake in providing vital care for patients. 

GPCE advocates for safe working and empowers practices to identify unfunded work in their regions and to engage in local action to address these commissioning gaps. Our safe working guidance has been GPC England policy for a decade and continues to be so. We will continue to update our guidance in line with contractual changes as they develop. Contractual asks, such as patient access to e-consultations for routine care as well as requesting fit notes or medication queries, does not mean GPs must offer unlimited capacity that jeopardises safe patient care.

When locally commissioned pathways are poorly resourced or absent, practices must renegotiate with LMCs and ICBs (Integrated Care Boards) to secure appropriate resourcing.

Practices who are undertaking such unfunded work should either be resourced, to ensure patient care is sustainable, or with LMC guidance, should consider serving notice to ICBs. LMCs are integral to facilitating fair and effective local agreements for practices - supported by our resources and national advice. 

We still have the template letters available to help practices manage workload and limit capacity to deliver safe, high-quality care.