If your employer has decided the practice will be participating in local actions

1. Partners or contractors should instruct salaried GPs what local action the practice will be taking

If your practice decides to undertake any of the above actions, you should expect to be instructed by your employer to change your way of working.

For the action to be effective, it is imperative that contractors or partners instruct the salaried GPs they employ to take the same action. These local actions will be most effective when the changes to working are adopted by the entire clinical team, including sessional GPs. You should not see any increase in your workload as a result of local action. General practice must be united to make change.

2. Any local action which will significantly change ways of working needs to be clearly communicated, ideally in writing, to salaried GPs

If the local action that your partner or contractor decides to take will significantly change ways of working at the practice, and therefore your working day, this should be clearly communicated to you, preferably in writing. The changes made to how you work and the anticipated duration of these changes should be clearly explained, preferably in writing, to ensure shared understanding and clarity. Any further changes to working patterns, for example if your practice ‘adds’ local actions, should be communicated at least a week before implementation and with explanatory notes provided to staff.

3. If local action will change ways of working, changes to the salaried GP’s job plan should be made by mutual agreement

Partners and contractors should hold discussions with their salaried GP staff to clarify the proposed changes to work patterns as a result of taking local action. Only by mutual agreement should changes be made to the salaried GP’s job plan. 

It should be clarified whether the changes are time limited (i.e. only for a period of action) or a permanent change. In particular, we expect the adoption of safe working principles to continue and become a permanent positive change for all of general practice, and this should be reflected in salaried GPs’ job plans. 

If the change is time limited, this should be outlined in the job plan and a date set for a proposed job plan review. 

It is important for salaried GPs to be engaged in and supportive of taking local action, and this can be achieved by employers making concerted efforts to include all practice staff in conversations about the campaign, aims and desired outcomes. 

If your practice or partner is taking part in local action but does not want you to

As per usual practice working, salaried GPs must follow the reasonable instructions of their employer in order to avoid being in breach of their contract. If your employer has not instructed you to work differently, you should continue to work as outlined in your contract and existing job plan. 

If the partners or contractors at your practice have decided to implement some local actions, but you are not being directed to work differently, this could be because they have opted for action which does not directly impact on sessional GPs.

Alternatively, if your employer has introduced local actions that could result in a change to the way salaried GPs in your practice work, such as the recommended safe maximum of 25 patient contacts, but has only enabled/instructed contractors or partners to work in this way, please contact the BMA for advice. 

If your practice or partner is taking part in local action but you do not want to

As per usual practice working, salaried GPs must follow the reasonable instructions of their employer in order to avoid being in breach of their contract. Changes to your job plan should only be implemented by mutual agreement. Where a local action involves clinical judgement, however, normal Good Medical Practice principles apply and it is the individual’s responsibility to determine whether they can deliver safe patient care. 

If ultimately, the GP determines that specific action is against their clinical judgement, they must be able to demonstrate they have made the clinical decision in the patient’s best interest. If the individual has concerns about the safe delivery of patient care during the period of the action, they should follow the GMC’s on raising and acting on concerns about patient safety.

Will undertaking local action impact on salaried GP pay?

No. These actions are regarding the delivery of services as directed by the partners at each practice. This should not have any impact on the terms and conditions of salaried GPs. If your employer says they are having to change your employment conditions (e.g. pay, working hours, etc.) due to their participation in the action, please contact the BMA for advice.