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, local action remains crucial to address persistent commissioning gaps. Therefore, there are some local actions that partners may wish to continue taking.
General practice is broken. We are delivering more appointments to more patients with fewer GPs and less funding. The investment that comes with the 2025/26 GP contract is just the start on the long road to recovery and there are local actions that practices can continue to take to prioritise their delivery of safe, high-quality patient care.
These local actions are a lifestyle change. They are about taking steps to control workload, ensure well-commissioned pathways.
This is a commissioning dispute - it is not directed at secondary care clinicians. We need to stay united.
How could GP local ongoing action impact secondary care services?
GPCE recognise that local actions taken by practices could impact those working in hospitals.
Potential impacts may include:
- Work redirected to emergency departments and other urgent care settings
- Congestion within elective and discharge pathways
- Higher referral rates, requiring additional triaging by secondary care doctors
- Additional administrative workload for consultants, if letter-based referrals replace proformas.
How can secondary care colleagues support GPs taking local action?
GPs’ non-commissioned work:
GPs may decline to investigate or prescribe due to a lack of a locally commissioned or adequately resourced pathways. GPs do not want work to be unloaded on you without any allocated time or additional pay. You and your LNC can pressure the trust board and ICB to commission resources for general practices to do this work, in partnership with the LMC, or for the work to be resourced and included in jobs plans for secondary care colleagues to do.
Clear communication
Ensure clear and timely communication and share essential contact details with GPs after patient consultations.
Support in investigations
Refrain from asking general practice to organise investigations and specialist tests.
Med3s (fit notes)
Offer med3s (fit notes) to all working-age patients upon discharge as medically appropriate, in alignment with hospital contract obligations.
Follow up
Communicate any results and follow-up care to the patient.
Referral and prescribing
Follow locally agreed prescribing principles on discharge and from outpatients. Arrange appropriate onward referral, if necessary.
Offer direct advice
If a GP requests advice, please offer this and if the patient’s needs would be best met by a referral, then please advise accordingly. Your trust is allocated resources for Advice & Guidance as if it were an outpatient appointment, but GPs do not get resources for using your advice to prevent outpatient appointments/escalation to secondary care. If you are not receiving job planned time for responding to GP requests for advice or guidance, you can raise this in job planning negotiations and with your LNC.
Inform the ICB and LMC
If pathways need to be reviewed to ensure sufficient outpatient capacity; GPs may be able to help.
We appreciate your support. Should you need further assistance, please contact your Local Negotiating Committee Chair or regional representative, who can coordinate with colleagues in general practice.
We want the medical profession united. We will not let ICBs and trust management divide us.
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