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GP Collective action – Secondary care guidance

Thank you all for continuing to develop and expand on our collective action to protect our patients and practices

We recognise the particular challenges across the primary and secondary interface, and want to ensure all specialist colleagues are aware of the purpose and aims of GP Collective Action. To this end GPC England and the UK Consultants Committee have developed explanatory resources hospital and trust-based colleagues.

Our new webpage https://www.bma.org.uk/secondarycareGPaction outlines how secondary care colleagues may be affected and ways they can support GPs in this campaign. This includes a downloadable PowerPoint presentation which LNCs (Local Negotiating Committees) can use in their patch, an at-a-glance fact sheet that can be displayed in Trusts, and a recorded webinar offering further insights.   

Please also continue to refer to our collective action Protect your patients, protect your practice webpage, which explains in more detail the nine actions that practices can choose to take. It also contains more information such as the Safe Working Guidance HandbookCampaign resources and Patient materials.

As negotiations for the GP contract 2025/26 progress, this is a pivotal moment for all GPs to unite as a profession – not just for safe and sustainable general practice, but for a safe, sustainable and stronger NHS too. 

Primary care joint parliamentary event 28 January

Last week GPC England jointly hosted an MP parliamentary drop in event for MPs in Westminster. The event on the future of primary care was held jointly with the British Dental Association, Community Pharmacy England, the Optometric Fees Negotiating Committee and the Association for Primary Care Audiology Providers and was attended by over 40 MPs. These included members of the health and social care select committee and shadow health ministers. During the event we outlined key concerns related to workforce and funding and encouraged MPs to sign a joint letter to the Health Secretary calling for increased support for primary care.

Special England LMC Conference 2025

The Special England LMC Conference will be held on Wednesday 19 March 2025 at Friends House, London. This was supported during the Conference of England LMCs held in November last year, as an opportunity to evaluate the critical state of general practice in light of any government contractual offer for 2025/26, and ahead of the Spring three-year Spending Review and the publication of the NHS Ten Year Plan:

The focus will be to discuss and determine what escalatory steps will be needed to ensure the survival of what still remains of English general practice. 

Please note that the deadline for registration is Monday 17 February 2025 and no late requests for registration will be accepted after this date. Instructions to register have been sent to LMCs. Thank you to all LMCs who have submitted motions.

If you have any questions, please email info.lmcconference@bma.org.uk.

Help address the GP unemployment crisis 

Despite the rising demand for family doctors to provide care, a Kafkaesque situation now exists in which a significant number of highly skilled GPs are struggling to secure work.

The BMA’s UK Sessional GP Committee is looking for salaried and locum members to help highlight this pressing and absurd situation of the growing unemployment/underemployment crisis among GPs. Please take a few minutes to share your experiences by completing our survey.

Your input is critical to understanding the full extent and impact of this crisis and to strengthen our lobbying efforts for tangible change. 

Join the sessional GPs unemployment virtual rally

Wednesday 12 February, 7.30-9pm|We invite you to join this virtual rally and address the urgent issue of sessional GP unemployment. This is your chance to be part of the campaign, share your voice, and mobilise for change. 

Together, we can amplify our message and advocate for progress, plus, you can learn how the BMA is committed to supporting you and all GP colleagues. 

Register here  

NHS Mandate and NHSE planning guidance - improving access to general practice

Published last week, the UK Government’s new mandate for the NHS and NHS England’s planning guidance for 2025/26both emphasise improving patient access to general practice and primary care. Neither document establishes clarity in terms of how this will be achieved, but the new Mandate does refer to investment in upgraded GP surgeries and in data and digital tools. 

2023-24 type 2 pension forms for sessional GPs

We have recently highlighted the change of form and upload process for type 2 pension forms for 2023-24. Sessional GPs are required to complete a Type 2 Self-Assessment for each pension year, so that NHS England can ensure that all NHS pension contributions have been correctly paid and then accurately allocated to that GP’s NHS Pension Scheme record.

The relevant forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted to PCSE by 28 February 2025. PCSE and the BMA Pensions Committee have held two webinars to explain the new form and the process to upload the forms. Watch a recording of the webinar

UK LMC Conference – Deadline reminders

The deadlines for the UK LMC conference being held on 8 and 9 May in Glasgow are as follows:


Motions should be submitted via this form by 12 noon, on 17 February 2025

Registration deadline is 3 April 2025 and you can register here

For instructions on how to submit motions and register, please see the email sent on 6 December 2024.

Please note that if you haven't been registered by this deadline you will not be eligible to attend the conference, even if hotels/trains etc have been booked. It is the LMC’s responsibility to ensure that all their reps and observers are registered.  If you are unsure if you have been registered, then please email Karen Day at kday@bma.org.uk. Any other queries can be sent to info.lmcconference@bma.org.uk

Resident Doctor dispute on exception reporting

Despite its best-efforts during negotiations, the BMA’s UKRDC (UK resident doctors committee) have announced they will be entering into a dispute with the Government over the contractual reform of exception reporting (ER).  The GPRC (GP registrars committee) met last week and passed a motion which offers their full support to UKRDC in entering a dispute to drive the negotiations to an effective resolution. Read more here

GPC England Regional Elections – coming soon

GPs Committee England will soon be seeking nominations for voting members of the committee for the 2024-2027 sessions, we will be electing one representative from each of the following regions:

  • Cambridgeshire and Bedfordshire
  • Hertfordshire
  • North and South Essex
  • Barking & Havering, Redbridge & Waltham Forest and City & Hackney
  • Cumbria and Lancashire
  • Wigan & Bolton, Bury & Rochdale and West Pennine
  • South & West Devon and Kernow
  • Hampshire and Isle of Wight
  • Kent
  • Surrey and Croydon
  • East Yorkshire, North Lincolnshire and Lincolnshire
  • Calderdale, Kirklees, Leeds and Wakefield

For more information about BMA elections

GPCE Guidance, media and contacts

  • Campaign materials (patient leaflets, lanyards, badges, window stickers) on the BMA rep Hub

Read the latest GPCE bulletinGP collective action | primary care parliamentary event | special England LMC conference

Update from GPC England

It may appear quiet on the GPCE front, while we are focused on negotiations with Government, DHSC and NHSE, which we anticipate will conclude next month. The Secretary of State, Wes Streeting wrote to me last week, and I shall be meeting the Minister for Primary Care, Stephen Kinnock later this week. 

Government is well aware of the upcoming Special England LMC Conference on Wednesday 19 March to focus on potential ‘escalatory steps needed to ensure the survival of what still remains of English general practice’ (further details below), and the lack of GP employment opportunities. The Special Conference is also to consider the 2025-26 offer from the DHSC / NHSE. The key milestone however, was always going to be the Spring 2025 three year spending review – Treasury's instruction manual for planned costs between now and 2028. This is where, together with the NHS Ten Year Plan, we need to see practice resource restoration set out and a new substantive contract for practices across England, as iterated in our manifesto Patients First.

GP Unemployment Crisis & ARRS Roles

NHSE has written to Primary Care Networks (PCNs) encouraging them to use their GP ARRS funding in 2024/25 to recruit recently qualified GPs. NHSE states they will be monitoring the data on the number of GPs recruited, and are doubling down on ICBs to work with those PCNs who have not yet taken advantage of the GP ARRS funding. The Secretary of State is no doubt frustrated that despite removing the barriers to enable GPs to be recruited, his announced target of 1000 new GPs is far from being realised, yet the numbers of unemployed GPs continue to make headlines. The reason is simple – the ARRS mechanism is not appropriate for GP roles, and the funding is woefully insufficient. 

The failure for GPs to find work, often when newly-qualified, but increasingly more generally, is completely unacceptable. It is estimated that between 20-33% of GP Registrars are failing to secure substantive roles after qualifying. Training more GPs whilst depriving practices of the necessary funds to recruit those same GPs is a failure of NHSE. Worse still, even when joining the profession, 25% of these GPs appear to be leaving their roles.

ARRS GPs are not the answer to ‘bringing back the family doctor’. Rather than 1000 new GPs, comparing December 2024 with June 2024’s data there was a gain of a mere 111 (FTE) salaried GPs, and 8 (FTE) locums. There are currently estimated to be around 3500 under-employed or unemployed (FTE) GPs out there. There is an opportunity to change this for 2025/26, if NHSE take it. Please join the BMA’s UK Sessional GP Committee on their Virtual Rally on Wednesday 12 February – see below.

Special England LMC Conference 2025

A Special England LMC Conference will be held on Wednesday 19 March 2025, at Friends House, London. This was requested during the Conference of England LMCs on Friday 22 November to further assess the critical state of general practice in light of any government contractual offer, and ahead of the Spring three year spending review and the publication of the NHS Ten Year Plan:

The focus will be to discuss and determine what escalatory steps will be needed to ensure the survival of what still remains of English general practice. 

  • The deadline receipt of motions for the Special LMC Conference has now passed (noon, 27 January) 
  • The deadline for registration is Monday 17 February 2025.

Instructions to register and submit motions have been sent to LMCs. If you have any questions, please email info.lmcconference@bma.org.uk.

Help address the GP unemployment crisis

Despite the rising demand for family doctors, an appalling paradox exists where a significant number of highly skilled GPs are struggling to secure work.

The BMA’s UK Sessional GP Committee is looking for salaried and locum members to help highlight this pressing and absurd situation of the growing unemployment crisis among GPs. Please take a few minutes to share your experiences by completing our survey.

Your input is critical to understanding the full extent of this crisis, and strengthening our lobbying efforts for meaningful change. 

Join the sessional GPs unemployment virtual rally

Wednesday 12 February, 7.30-9pm|We invite you to join us in addressing the urgent issue of sessional GP unemployment. This is your chance to be part of the conversation, share your voice, and mobilise for change. 

Together, we can amplify our message and advocate for progress, plus, learn how the BMA is committed to supporting you and all GP colleagues. Register here  

GP collective action 

Thank you for continuing to build on our collective action to protect our patients and practices

We recognise the challenges across the primary and secondary interface, which is why GPCE and UK Consultants Committee are working together to produce resources to help ‘translate’ collective action for our hospital and trust-based colleagues. 

There will be a mailout to the profession from the BMA Chair of Council very soon to all branches of practice to explain and galvanise support for GPs from secondary care colleagues, alongside a microsite with links to multiple resources including slides which LNCs can present and ‘at a glance’ fact sheets to and explain that secondary care doctors can stand shoulder to shoulder with GP colleagues. 

Safe working guidance – ‘core’ general practice

As part of the safe working guidance for GP practices in England, we have developed a section focusing on ‘core’ general practice to help you identify which services are included within ‘core GMS’.

It’s essential that GPs and practices focus on delivering services that are properly commissioned and resourced. It is not always clear which services are included within ‘core GMS’, leading to some practices potentially offering unfunded services. To help clarify, we’ve compiled a list of locally commissioned services that should be commissioned separately. If your practice is asked to provide un-commissioned services, we recommend declining and working with your local ICS (integrated care system) to ensure proper commissioning.

Explore the list of services and learn more

Westminster update

The fourth day of Committee stage on the National Insurance Contributions (Secondary Class 1 Contributions) Bill be taken on Thursday 6 February, we continue to brief peers on the Bill, and have received ongoing mentions throughout committee stage. You can read the latest debate here

GPCE deputy chair, Dr David Wrigley this week provided oral evidence to the Health and Social Care Committee to inform their evidence session on What progress is being made in preventing cardiovascular disease. During the session he outlined the role GPs played in providing health checks, the use of IT to identify patients at risk of cardiovascular disease, and the impact of outsourcing health checks on patients, and the wider health services. 

We briefed MPs ahead of a Westminster Hall debate on doctor welfare tabled by consultant Dr Peter Prinsley MP. During the debate he commented, “Our GPs are under pressure as never before. Who is looking out for them? They face massive lists of patients and huge demands. We know that we must support them, for they are the front door of our NHS”.

GPCE leaders attended a report launch in Westminster by Pulse and its publishers Cogora showing that around a quarter of salaried GPs and locums are looking for a permanent role at the same time as practices are facing a shortfall in GP numbers. This important report highlights the concerns which the BMA has been raising regarding GP unemployment. 

LMC Secretaries Conference 2025

The LMC secretaries conference is taking place on Friday 7 February 2025 at BMA House in London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is Friday 24 January 2025. 

Please contact the GPC office at info.lmcconference@bma.org.uk with any queries.

GPC Preventing sexual misconduct in the workplace - live webinar Thursday 6 February, 1-2pm

This live webinar will explain NHSE’s new work to prevent sexual misconduct at work, including the sexual safety charter and what they want employers to be doing to support staff. It will also explain the role of the BMA in providing support to our members who have been a target of sexual misconduct and how doctors can be better allies when they witness this behaviour at work. Register for free here

GPC England Regional Elections – coming soon

GPs Committee England will soon be seeking nominations for voting members of the committee for the 2024-2027 sessions, we will be electing one representative from the following regions:

  • Cambridgeshire and Bedfordshire
  • Hertfordshire
  • North and South Essex
  • Barking & Havering, Redbridge & Waltham Forest and City & Hackney
  • Cumbria and Lancashire
  • Wigan & Bolton, Bury & Rochdale and West Pennine
  • South & West Devon and Kernow
  • Hampshire and Isle of Wight
  • Kent
  • Surrey and Croydon
  • East Yorkshire, North Lincolnshire and Lincolnshire
  • Calderdale, Kirklees, Leeds and Wakefield

For more information about BMA elections

GPCE Guidance, media and contacts

  • Campaign materials (patient leaflets, lanyards, badges, window stickers) on the BMA rep Hub

Read the latest GPCE bulletinSpecial England LMC conference | sessional GP unemployment | collective action

Dr Katie Bramall-Stainer

Chair, GPC England

Email: info.lmcqueries@bma.org.uk (for LMC queries)Email: info.gpc@bma.org.uk (for GPs an

This week the Government has made a number of announcements, including resourcing GPs to deliver Advice and Guidance (A&G) at £20 per episode to be able to sort out clinical issues and queries you have about a patient. At least £80m has been earmarked for A&G use and this is in addition to the £889m announced by the Secretary of State on 20 December. 

This is a small positive step and something we had already suggested to the government. Suspending A&G is one of the items on our Collective Action menu as an unresourced piece of work, but if this is successfully negotiated into the 25/26 contract and fairly resourced, then it could be dropped from the menu. We have yet to see any detail on how the A&G plan will be rolled out and will advise you about this as soon as we can. We are in active discussion with government on this and other contract issues. 

Many of you want to see significant investment going into uplifting core contracts, and of course we are all doing more work than ever before, in the knowledge that our share of NHS funding is at a very low level. We will continue to press this issue in our current negotiation meetings. 

We hope this is the beginning of NHSE and ICBs making sensible decisions about where it is best to invest, and this seems to be an example of the Government’s commitment to increase funding into general practice. It is a small step forward on the journey to what we really need. But as ever – nothing is agreed until everything is agreed and we are now actively engaged with NHSE and the Department of Health on proposed contract changes for April 2025 and beyond.

Watch the video recorded by GPCE Chair, Dr Katie Bramall Stainer, for a full update on the key issues.

There is a statement by the GPCE, in response to the Government’s announcement of an £889m funding uplift for general practice in England for 2025/26, as set out in the letter from Wes Streeting MP on 20 December.

As ever thank you for all you do for your patients and your practice and let us hope 2025 is a better year for us all so we can make NHS general practice sustainable for the future.

January 2025 collective action tracker survey

The January collective action tracker survey will open on Monday 13 January and will remain open for two weeks, closing on 26 January at 5pm. Your response to this is hugely helpful to us and we would ask you take a few minutes to complete it. 

Is your practice taking part in collective action? We encourage all GP partners or practice managers to share their experiences by completing this short survey. No identifiable data will be created as a result of this survey. 

We have produced guidance around individual collective actions to support practices in undertaking specific actions. Please refer to our refreshed Safe Working Guidance Handbook and to the BMA’s GP campaign webpage for more information. We appreciate your participation in collective action. 

Special England LMC Conference 2025

The Special LMC Conference will be held on Wednesday 19 March 2025 at Friends House, London. The day will start at 10.00am and finish at 5.00pm. LMCs may wish to bear this in mind when arranging transport and accommodation. 

This Special Conference was called at the 2024 Annual Conference of England LMCs. Under Standing Order 2 the only business to be considered will be “to discuss and determine what escalatory steps will be needed to ensure the survival of what still remains of English general practice”. 


Instructions to register and submit motions have been sent to LMCs.

  • The deadline receipt of motions for the Special LMC Conference is noon, 27 January 2025 
  • The deadline for registration is Monday 17 February 2025.

If you have any questions, please email info.lmcconference@bma.org.uk.

LMC Secretaries Conference 2025

The LMC secretaries conference is taking place on Friday 7 February 2025 at BMA House in London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is Friday 24 January 2025. 

Please contact the GPC office at info.lmcconference@bma.org.uk with any queries.

The National Insurance Contributions (NICs) Bill

Following its passage through the Commons, the National Insurance Contributions Bill moved to the House of Lords where it was debated on 6 January. During the debate a motion of regret was tabled, which if agreed would signal the House disagreed with the Bill but would not stop its progress. In the event the motion was not agreed. However, there was significant debate with the BMA mentioned numerous times along with our concerns regarding the impacts of employer NICs increases on practices and patients. We have undertaken extensive lobbying and briefing of Parliamentarians prior to the debate. The Bill will next go to committee stage in the Lords, where the BMA will continue to lobby. 

BMA Guidance on physician associates

In response to member queries regarding the future management of physician associates (PAs) within their practices, please note the additional guidance below:

GP practices are entitled to follow BMA Guidance and RCGP guidance on employing PAs. However, it is for individual practices to decide whether to follow the guidance, and if they do decide to follow it, what steps to take to implement any changes.

A GP practice may decide to restructure how they deliver their services in order to follow the guidance. If such a restructure results in duties being removed from one or more PA in the practice, this could result in a redundancy situation arising, i.e. where there is a reduced requirement for physician associates to carry out work of a particular kind.

As a GP partner, and BMA member, if redundancy is an option your practice is considering, or you have questions regarding how to manage the employment relationship with your physician associate, please contact the BMA Employer Advisory Service  at the earliest opportunity.

GPC England Regional Elections – coming soon

GPs Committee England will soon be seeking nominations for voting members of the committee for the 2024-2027 sessions, we will be election one representative from the following regions:

  • Cambridgeshire and Bedfordshire
  • Hertfordshire
  • North and South Essex
  • Barking & Havering, Redbridge & Waltham Forest and City & Hackney
  • Cumbria and Lancashire
  • Wigan & Bolton, Bury & Rochdale and West Pennine
  • South & West Devon and Kernow
  • Hampshire and Isle of Wight
  • Kent
  • Surrey and Croydon
  • East Yorkshire, North Lincolnshire and Lincolnshire
  • Calderdale, Kirklees, Leeds and Wakefield

Please look out for an email to BMA members coming soon. For more information about BMA elections

Virtual rally on sessional GP unemployment

Join us as we unite to tackle the pressing issue of sessional GP unemployment on Wednesday 12 February, 7.30-9pm.This is your chance to be part of the conversation, share your voice, and mobilise for change. During the rally, you’ll learn about the latest insights on the issues, what the BMA has been doing, updates on GP collective action in England, ways to get involved with your LMC to drive change, and more. Speakers include BMA Chair of the Sessional GPs committee, Chair of GPC England, Co-chairs of the GP registrars committee, and a RCGP representative.

Let’s raise our collective voice and demand progress. Together, we’ll ensure the challenges faced by sessional GPs remain a priority. Gain valuable insights, actionable steps, and learn how the BMA is standing with you. Register here

BMA and PCSE webinars for 2023-24 type 2 pension forms for sessional GPs

We previously highlighted the change of form and upload process for type 2 pension forms for 2023-24. As a salaried GP, out of hours GP or long-term locum within a practice, you are required to complete a Type 2 Self-Assessment for each pension year, so that NHS England can ensure that all NHS pension contributions have been correctly paid and allocated correctly to the NHS Pension Scheme record. 

The relevant forms must be completed by members who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted to PCSE by 28 February 2025. PCSE have scheduled two webinars to explain the new form and the process to upload the forms. The deputy chair of the BMA pensions committee, Krishan Aggarwal, will also be attending the webinars to support member queries. These will be held on:

Please click here to register for the webinars.

The BMA is here to support you and you can find more details about these changes on our webpage >

RCGP clarifies new exam attempts policy

In August 2024, the BMA won a ‘landmark’ legal judgement, supporting a trainee GP who believed they had been unfairly treated due to the way the RCGP applied its policy on the number of attempts at taking an exam. The judge found that it was irrational for the College to refuse to consider further attempts or nullification in the event that a candidate reports a late diagnosis that would have justified reasonable adjustments, quashing the policy both prospectively and retrospectively. 

The RCGP has now confirmed their replacement policy, which applies to both the AKT and the SCA:

Where after an unsuccessful attempt a candidate receives a diagnosis of a disability of which they were previously unaware, the RCGP may void any previous attempts which they took while having that disability without the appropriate reasonable adjustments. The candidate would still have the same upper limit of maximum attempts as they were entitled to when they entered training for the first time. Applications for previous attempts to be voided are subject to all other applicable MRCGP Regulations and Policies, including rules on eligibility and timeframes. 

The RCGP’s website includes FAQs on the new policy and registrars who believe they may be eligible for additional attempts should complete this form.

All-Party Parliamentary Group on Pharmacy - Call for written evidence on medicines shortages

The All-Party Parliamentary Group (APPG) on Pharmacy has launched an inquiry into the impact of medicines shortages, and a call for written evidence from key stakeholders across the healthcare sector. 

We would encourage individual GPs to submit written evidence on the impact medicine shortages have on practices and patients (deadline 24 January) – submit your evidence here

GPCE Guidance, media and contacts

  • Campaign materials (patient leaflets, lanyards, badges, window stickers) on the BMA rep Hub

Read the latest GPCE bulletinInvestment in general practice | collective action tracker | special England LMC conference

Collective action 

Thank you for taking part in our collective action to protect our patients and practices. 

We have updated our collective action webpage explaining in more detail the nine actions that practices can choose to take. These actions will continue to make a difference: they are safe, sustainable, and do not breach your contract. If GPs collectively participate, this helps put pressure on the Government to do the right thing for patients and general practice.

Please also refer to other useful links such as:

Watch our video of colleagues explaining the importance of taking collective action: https://youtu.be/tH1FFyIfyBA

Make sure you are involved to protect your patients, your staff and your practice.

As the year comes to an end, we wanted to thank you all for your continued work in general practice and for your help and support in the work we do. 

Please do keep in touch and best wishes for 2025. 

December action tracker

The December collective action tracker survey will close at 5pm on Sunday 15 December.  

Is your practice taking part in collective action?  We want to hear from you! If you are a GP partner or a practice manager, please fill in this survey. Specific data will not be shared outside of the BMA and no identifiable data will be created as a result of this survey. 

National Insurance contributions

The BMA briefed MPs ahead of the opposition day debate on the increase in employers’ national insurance (NI) contributions, and we were pleased to see several MPs raising the issue of the impact of the increase on GPs and their patients and urging government to take action. 

This issue was also raised in Prime Ministers Questions, where Liberal Democrat MP, Martin Wrigley, highlighted that GPs in his constituency had contacted him with concerns and asked the PM to release this funding information. The PM stated that the Darzi report made clear that the NHS was broken by the last government, which is why they have committed £22 billion to the NHS in this year’s budget. He stated that his government value the vital work that GPs do, and every year they consult with the sector on the services they provide and the money they are entitled to in return.

To continue to keep this issue on the government’s agenda, if you have not done so please write to your local MP, using our online tool to tell them about the impact that ENICS increases will have on your practice and patients. Please also consider following up your email with an invitation for your local MP to visit your practice to hear from you directly. If you do have an MP visiting, contact us on publicaffairs@bma.org.uk, and we can offer any support needed.

Please continue to use the BMA online calculator to estimate the impact of the increases to employer NI contributions and the national minimum/living wage on general practice in England.

Data from our online calculator submissions so far indicates that the average additional cost pressure runs to around £33,000 for each practice. This means practices are at risk of closure or, as a minimum, reducing staff and services as a result, if these additional costs are not covered. 


Calling all GPs: Join us at next year’s ARM in Liverpool

If you are interested in helping to set BMA policy, you can now nominate to be a representative for your local area at the annual representative meeting (ARM) 2025 (23-25 June). 

The ARM decides the future of your union and professional association – from pay restoration and resourcing the NHS, clinical governance to the GMC, to electing your leadership. Over half of the seats to ARM are allocated to BMA divisions, with others allocated to BMA conferences. Elections are conducted via the BMA's online nomination and election system across all division areas in the UK. This means that all BMA members can nominate and vote in their division elections. Find out more.

Please visit our elections portal to nominate yourself (Nominations will close at 12pm on Tuesday 14 January 2025.) 

If you have any questions, please contact elections@bma.org.uk

Joint statement on Government pay uplift for 2024/25

We recognise decisions on pay awards for practice staff are determined by individual employers, however, nursing staff working in general practice should be provided with a fair pay settlement that recognises their essential nursing role in the holistic delivery of general practice services. 

GPCE and RCN are committed to calling for a fairer funding model general practice nursing staff, and remain committed to finding solutions to achieve this and secure the long-term sustainability of general practice in England. Read the full statement here

Government’s suggested 2.8% pay uplift for doctors for 2025-26

This week, the Government recommended that the pay uplift for next year for doctors and other NHS workers should be 2.8%. In response to this, the BMA's chair of council, Philip Banfield, said:
 
"For this Government to give evidence to DDRB believing a 2.8% pay rise is enough, indicates a poor grasp of the unresolved issues from two years of industrial action. It is far below the current rate of inflation experienced by doctors in their daily lives and does not move significantly closer to restoring the relative value of doctors’ pay lost over the past 15 years.” Read the full BMA statement

Changes to the GP pension type 1 and 2 forms for the year 2023-24

You should have received an email from NHS England detailing how you must submit your type 1 or type 2 form for the year ending 31 March 2024 to PCSE. Previously you could submit your forms either through your PCSE online account or the 'Contact us' section on the PCSE website. Instead, you or your accountant, will now need to submit the form via the ‘Contact us’ section on the PCSE website. This will not impact your pension record, just how you submit your forms.

All of the necessary forms, including the Type 1 form for GP partners, and guidance are linked on our webpage. The forms must be completed by those who have undertaken practitioner pensionable work between 1 April 2023 and 31 March 2024, and should be submitted by 28 February 2025.

What does the future hold for GP premises?

Listen to the GP online podcast with Dr Gaurav Gupta, GPC England lead for premises, who talks about the terrible state of GP premises in England. He explains what the new premises cost directions could mean for practices, the problems facing practices based in NHS Property Services buildings and why GP premises ownership should still have an important role in future plans for the primary care estate.

LMC England Conference 2024 update and resolutions

Chaired by Waltham Forest LMC’s Dr Elliot Singer, your national representative conference of representatives of England LMCs was held on 22 November. The title “Truth and trust: valuing family doctors” framed the debates and discussions of the 300+ LMC representatives present.  Read the resolutions and election results and watch the recording of the event here.

Updated GP training guide

After a year of negotiation with COGPED (Committee of GP Education Directors), the GP Registrars committee has launched an updated guide for GP registrar sessions, bringing practical improvements to training. It supports flexible working patterns, allowing registrars to follow either session or hour-based schedules as per their contract. Appointment times are now adjustable based on training stage and consultation complexity, with a goal of reaching 15-minute face-to-face consultations by the end of training. The guide promotes both flexibility and tailored support, reflecting the evolving needs of GP registrars. For full details, read the document on the BMA website.

BMA’s Change NHS / 10 Year Health Plan consultation response

The BMA has submitted its organisational response to the Change NHS consultation, to help influence the UK Government’s 10 Year Health Plan. The BMA’s response centres on the need for the plan to ensure that doctors are better valued – financially, professionally, and culturally – and stresses the importance of increased support and investment for general practice. 

Cameron Fund Christmas Appeal 2024

The Cameron Fund is the only medical benevolent fund that solely supports GPs and their dependants in times of financial need, whether through ill-health, disability, bereavement, relationship breakdown or loss of employment. Each year the Cameron Fund runs a Christmas Appeal to raise extra funds for their beneficiaries. If you would like to make a donation, please find further details here.

LMC Secretaries Conference 2025

The LMC secretaries conference is taking place on Friday 7 February 2025 at BMA House in London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is Friday 24 January 2025. 

Please contact the GPC office at info.lmcconference@bma.org.uk with any queries.

UK LMC Conference - 8 and 9 May 2025 - Save the date

The UK LMC Conference 2025 will be held on Thursday 8 and Friday 9 May 2025 at the SEC Centre in Glasgow, Scotland.  The Agenda Committee continues to work on the Reforms to Conference mandated, and aims to bring further updates and progress in 2025, including substantive changes to Standing Orders to ratify the changes necessary to make the UK Conference truly serve all four nations.

GPCE Guidance, media and contacts

Read the GPCE bulletinCollective action | NI contributions: try our calculator | our pay uplift statement

Read the sessional GPs newsletter: GP unemployment | GPs in ARRS | earnings report | lifestyle medicine and menopause

Read the GP Registrars newsletter: Hello, from your GP registrar committee

National Insurance contributions 

Last week, at the England national conference of LMCs, we debated the impact that the increase in employer National Insurance (NI) contributions have on GP practices and passed a motion demanding that the Health Secretary rectify the issue with funding to the core GP Contract.  

The BMA continues to put pressure on the Government regarding our concerns and the Chair of GPC England, Dr Katie Bramall-Stainer, referenced the response from the Secretary of State for Health in her speech to the Conference, where she said: 

"Mr Streeting recognises that we as GPs are so clearly the beating heart of the NHS family. We now need him to follow through and treat us as such". 

Please use the BMA online calculator to estimate the impact of the increases to employer National Insurance contributions and the national minimum/living wage on general practice in England. 

Data from our online calculator submissions so far indicates that the average additional cost pressure runs to around £35,000 for each practice. This means practices are at risk of closure or, as a minimum, reducing staff and services as a result. 

Help us to continue to put pressure on the Government by writing to your local MP and inviting them to your practices using our online tool > 

The recent announcement about the NI increase has hugely affected the morale of the profession. Listen to Dr Adam Janjua explain why it is necessary for general practice to come together and take collective action as “enough is enough”. https://www.youtube.com/watch?v=jBon3HpazRI 

Collective action  

Thank you to all those taking part in our collective action to protect our patients and practices. These nine actions will continue to make a difference: they are safe, sustainable, and do not breach your contract. For all General Practitioners to collectively participate continues to put pressure on the Government to do the right thing for patients and general practice. 

At the Conference of LMCs in England last week, the GPC England Chair, Dr Katie Bramall-Stainer explained why collective action is needed NOW, as grassroots GPs are telling us that "this is going to break us". Watch the speech: GPs are having to take collective action  

Make sure you are involved to protect your practice, your staff and your patients.  

Protect your Patients and Protect your Practice‘ campaign 

The BMA’s ‘Protect your Patients and Protect your Practice‘ campaign webpage has information about all of the actions. Please also refer to other useful links such as: 

Campaign materials such as patient leaflets, lanyards, badges, window stickers and Beanie hats continue to be available from the BMA rep Hub

We will be producing more guidance around individual collective actions to support those practices in undertaking specific actions. 

We want GPs to feel safe and empowered to take action to protect their patients and their practices.  

A blue and white sign

Description automatically generatedBMA GP opinion survey 2024 – Have you had your say yet? 

The BMA GP Opinion Survey is still open. This annual survey gathers GPs’ views on current issues facing General Practice and is helping to influence and inform this year’s contract negotiations, inn addition to our longer-term strategy of promoting and protecting the future of General Practice. 

It is open to GPs in England working in all settings and practices, including partners, salaried GPs, locums, and GP registrars at ST3 and above. 

Participants do not need to be a member of the BMA to participate but we will need a GMC number to ensure that responses are coming from eligible GPs based in England. All responses will be anonymised. 

Take the survey here: https://www.research.net/r/FP9JLQJ 

Data (Use and Access) Bill  

Changes to UK data protection law have been proposed in the government’s new Data (Use and Access) Bill which had its second reading in the House of Lords in November. Our briefing highlighted concerns about the potential impact on health data should there be a departure from existing high standards of data protection. The BMA is particularly concerned about the erosion of transparency standards when data is processed for research purposes and the threat to the regulatory independence of the Information Commissioner’s Office.  

The bill also addresses the technical deficit in the NHS that limits data sharing and sets out measures to address this. IT system suppliers will be forced to develop software for sale in the NHS in line with technical standards – which we have long called for, and our report on IT was acknowledged as a factor favouring the inclusion of  this measure. 

Government review of Physician Associates 

The Government has launched an independent review of physician associates (PAs) and anaesthesia associates (AAs). In response to this, the BMA Chair of Council, Dr Phil Banfield, welcomed that the Government has acknowledged the concerns of doctors and accepted there is a safety issue with the employment of physician associates. He said:  

“So we need to know what immediate safety measures NHSE will put in place, how quickly they will pause their PA expansion plans, and in the meantime if they will adopt the BMA’s own guidelines to start protecting patients now.” Read the full statement here

Read the BMA guidance: PAs in general practice: making it safe for patients and GPs 

Flu vaccination survey 

The NHS England vaccination strategy, launched in December 2023, contained a proposal for NHSE to explore the impact of a move to the centralised provision of flu vaccines. As part of that exercise, NHSE has launched a survey of  general practice and pharmacy providers to gather their views on both the current model of procurement, and the potential benefits and challenges of a centralised procurement model. Any such change will not be implemented for the 2025/26 season flu programme. 

The outcome of the survey will inform any future discussion on potential changes of the procurement model that NHSE will have with GPC England. As such we would encourage as many practices as possible to make their views known. Take the survey here 

GP pressures: latest workforce and appointment data 

A graph showing the number of patients per practiceGPs continue to treat many more patients than they have done in the past. The latest data shows a record 63.66 million patients registered with practices in England, while there are over 1,300 fewer fully qualified full time GPs compared to 2015. 

As a result, each full-time equivalent GP is now responsible for an average of 2,271 patients, an increase of 333 patients per GP (or 17%) since 2015, and appointments level at an average of almost 1.5 million per working day. Since September 2015, there has also been a decrease of 1,387 GP practices.   

This fall in both GP numbers and practices coincides with a rise in patient numbers, which is putting staff at GP surgeries under immense strain, with knock-on effects for patient care. 

Learn more about the pressures on general practice by visiting our website  

Do you look after asylum seekers or refugees? 

It is well-evidenced that this group of patients continue to face significant barriers accessing appropriate and timely healthcare. We’ve launched a survey to capture your experiences, so the BMA can update its Refugee and Asylum Patient Health Toolkit and influence government policy to better support you in enhancing healthcare services for asylum seekers and refugees. Share your views and complete this ten-minute survey by 14 December 2024. 

Conference of England LMCs 2023 

Thank you to those who attended the Conference of England LMCs.  We would appreciate your feedback to help us improve future events. Please use this form to send us your feedback. 

Conference News with the resolutions from Conference will be published some time next week. 

LMC Secretaries Conference 2025 

The LMC secretaries conference is taking place on Friday 7 February 2025 at BMA House in London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is Friday 24 January 2025.  

Please contact the GPC office at info.lmcconference@bma.org.uk with any queries. 

Read more about the work of GPC England and practical guidance for GP practices 

See the latest update on X @BMA_GP / X  and read about BMA in the media 

Read the latest GPCE bulletin

National Insurance contributions | GP collective action | take our annual survey 

Dear colleagues

The Budget NI Blow 

BMA UK Council met on Wednesday and emergency business included the Chair of Council, Professor Phil Banfield committing total support to our branch of practice, echoed in a formal statement subsequently shared across social media. Yesterday, GPC England met where we discussed the implications of the cost pressures, strategy for discussions with the heart of Government ahead of the national conference of LMCs next Friday 22 November, and first-hand experience of the personal impact on GP elected members. 

Early data from our BMA online calculator confidential submissions suggests cost pressures potentially running into the hundreds of thousands of pounds for GP contractors – whose practices may have to close or reduce staff and services as a result.  The BMA is putting pressure on the Government to guarantee these cost pressures be fully resourced, and has launched a calculator to estimate the impact on your practice. Please sit down and login with your practice manager and click submit to share your figures anonymously to help us build a picture of the reality facing practices.

We have created a calculator to help you estimate the impact from April 2025 of these increases to employer National Insurance contributions and the national minimum/living wage on general practice in England.

As well as ongoing discussions with the DHSC, we wrote to the Treasury in the immediate aftermath of the Autumn Statement and there have been ongoing questions put in the House of Commons, supported by BMA members using the MP letter tool to keep the pressure up on this evolving crisis. 

Help us to continue to  put pressure on the Government by writing to your local MP using our online tool

I spoke to the Medics’ Money podcast about pressures facing GPs and why the Budget was so devastating for the profession. The podcast covers:

  • The impact of the National Insurance employer contributions increase
  • Why and how GPs can take part in collective action 
  • Ongoing problems GPs face with PCSE processing pension records
  • The postcode lottery of LES funding 

Watch here or listen here

Read more here: www.bma.org.uk/BudgetNIblow

Collective action 

Thank you to every practice now taking part in our collective action to protect our patients and practices. These actionshave already, and will continue to make a difference: they are safe, sustainable, and do not breach your contract. This is turning up the pressure on the Government to do the right thing for patients and general practice. We are the bedrock of the NHS, but our services have been driven to near collapse.

We need you to take action to protect our patients and protect our practices.  

We are producing more guidance around individual collective actions to support those practices in undertaking specific actions. This week we are focusing on Advice and Guidance.

Watch our collective action video on advice and guidance  

This two-minute video shows GPC England’s views on this specific collective action. Dr Clare Bannon discusses how advice and guidance has been used when a referral would have been appropriate and that this has increased both work and risk for GPs. Using advice and guidance is not a contractual obligation, so as part of collective action, her practice is pushing back making it clear in referral letters that a patient should be provided with a consultation.

The BMA’s GP campaign webpage has more information about all of the actions. Please also refer to our Safe Working Guidance Handbook and other useful links such as the guidance for GP collective action for sessional GPs and GP registrars, background to the 2024/25 contract changes, waiting room/website videos and infographics that can be downloaded and displayed in practices. Campaign materials such as patient leaflets, lanyards, badges, window stickers and Beanie hats continue to be available from the BMA rep Hub.

We want GPs to feel safe and empowered to take action that protects their patients and their practices. 

November action tracker

The November collective action tracker survey opened on Monday 11 November and will close at 5pm on Sunday 17November. Is your practice taking part in collective action?  We want to hear from you! If you are a GP partner or a practice manager, please fill in this survey. Specific data will not be shared outside of the BMA and no identifiable data will be created as a result of this survey. 

The BMA is producing more guidance around individual collective actions to support those practices in undertaking specific actions. Please refer to our refreshed Safe Working Guidance Handbook and to the BMA’s GP campaign webpage for more information. We appreciate your participation in collective action. 

Data access and usage bill

A government bill presented to parliament is having its first debate on 19 November in the House of Lords – the legislation proposes measures to replace the ICO and amend the existing regulatory framework in several significant ways. It also includes provisions that will directly impact the NHS and primary and care including the establishment of a new regulatory framework to mandate NHS IT System suppliers to develop software that they sell to the NHS in line with technical information standards set by the NHS – something the BMA has long-called for, a fact that the government has acknowledged in the bill’s impact assessment. The BMA has briefed members of the House of Lords on the issues above as well as restating the case for adequate resourcing of data access requests made to GPs on behalf of patients.

GPC England Chair Dr Katie Bramall-Stainer has co-authored an editorial in this week’s BMJ alongside Jess Morley and Cori Crider calling for transparency around digital transformation: https://www.bmj.com/content/387/bmj.q2494

NHS England 10 Year Health Plan

DHSC and NHS England have launched a consultation – Change NHS – to help inform the development of a new 10 Year Health Plan. The consultation is looking for ideas on how the NHS can improve, as well as views on these three proposed ‘shifts’; moving more care from hospitals into the community; going from analogue to digital; and moving toward prevention and away from sickness. 

The BMA is developing its response to the consultation, but individual GPs and practice managers can also respond to a separate survey on the Change NHS website: https://change.nhs.uk/en-GB/

Focus on DDRB pay award

As part of our Guidance on the imposed 2024/25 GP contract, we have also published a Focus on document on the 6% DDRB pay award and how it is applied to the national practice contract baseline funding (‘Global Sum’) and allocated to practices.

General Practice Annual Electronic Self-Declaration (eDEC)

The electronic practice self-declaration (eDEC) is a mandatory collection which all GP practices in England must complete every year. The revised version was published on 11 October – read more here.

LMC England Conference 2024

The Agenda for the 2024 LMC England Conference in Friends House, London which takes place on 22 November, has been published. For more information see here. Please send any queries to info.lmcconference@bma.org.uk

Bringing back the family doctor: a roundtable discussion event

GPC England and the BMA Patient Liaison Group are inviting leading patient organisations to attend a roundtable meeting at BMA House on 28 November to discuss the recently published 'Patients First’ vision for general practice. GPCE are keen that this discussion will open up further opportunities for joint working as well as develop understanding of the patient perspective in response to:  

  • What immediate actions can be taken to meet patient needs without requiring additional funding 
  • Priorities for the forthcoming NHS 10-year plan  
  • What is needed in the short term for 2025/26 to stabilise GP services for patients  
  • How a new GP contract within this Parliament could ensure patients receive the care they need  

Do you look after asylum seekers or refugees?

It is well-evidenced that this group of patients continue to face significant barriers accessing appropriate and timely healthcare. We’ve launched a survey to capture your experiences, so the BMA can update its Refugee and Asylum Patient Health Toolkit and influence government policy to better support you in enhancing healthcare services for asylum seekers and refugees. Share your views and complete this ten-minute survey by 14 December 2024.

LMC Secretaries Conference - 7 February 2025
The LMC secretaries conference will be taking place on Friday 7 February at BMA House, London. If you are interested in attending please ensure you register to attend the event by Friday 24 January 2025. 

Each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer. An online application form for nominations is available here, and representatives will have to indicate if they are first or second place nominations on the online form. Places will be confirmed via email and the closing date is 24 January 2025.

Please contact the GPC office at info.lmcconference@bma.org.uk with any queries you have about the LMC Secretaries Conference or David Wood (david.wood@attend.org.uk), about travel and subsistence.


UK LMC Conference - 8 and 9 May 2025 - Save the date

The UK LMC Conference 2025 will be held on Thursday 8 and Friday 9 May 2025 in Glasgow, Scotland.  The event will be taking place at the SEC Centre, Scottish Event Campus, Glasgow, G3 8YW.

The Agenda Committee continues to work on the Reforms to Conference mandated at Newport in 2024, and aims to bring further updates and progress in 2025, including substantive changes to Standing Orders to ratify the changes necessary to make the UK Conference truly serve all four nations.

GPC Guidance, media and contacts

  • Campaign materials such as patient leaflets, lanyards, badges, window stickers and Beanie hats  available from the BMA rep Hub

Read the latest GPCE bulletin

National Insurance contributions | collective action | data access and usage bill

BMA GP opinion survey 2024

The latest BMA GP Opinion Survey has opened, and we need to hear from all GPs across the country. 

This annual survey gathers GPs’ views on current issues and opportunities facing General Practice, helping to influence and inform this year’s contract negotiations in addition to our longer-term strategy of promoting and protecting the future of General Practice.

The survey is open to all GPs in England, including partners, salarieds, locums, and GP registrars at ST3 and above. It is open to GPs working in all settings and practices, wider primary care roles, trusts, urgent care, and secure or out-of-hours settings.

Participants do not need to be a member of the BMA to participate but we will need a GMC number to ensure that responses are coming from eligible GPs based in England. All responses will be anonymised.

The survey will close on Monday, 11 November at 9am. We urge you to complete the survey as soon as possible, to ensure GPC England’s negotiating position is made as strong as possible.

Take the survey here: https://www.research.net/r/FP9JLQJ

Our vision for general practice  

Last week we launched our vision for general practice Patients First: why general practice is broken and how we can fix it, presenting solutions for the new Government to work with us in rebuilding a transformed general practice for the benefit of our patients and communities, and improving the long-term health of the nation. 

GPs need an extra 11p per day, that’s £40 per patient per year in 2025/26 to provide the patient care that is needed.   This investment will help support safer, better continuity of care for our patients, recruiting more GPs and delivering more appointments.

We’ve shared Patients First: Why General Practice is broken and how we can fix it with the Secretary of State for Health, the Department for Health and NHS England. We look forward to working with them to bring about necessary changes, working to shape policies that will help fix the front door to the NHS and bring back the family doctor.

Safeguard general practice, and you safeguard the NHS. 

Please share our vision with patients, friends and colleagues, while continuing to take collective action that will protect our patients and our practices.

www.bma.org.uk/patientsfirst

Read our press statement

Collective action 

Thank you to every practice now taking part in our collective action to protect our patients and practices. These actions have already, and will continue to make a difference: they are safe, sustainable, and do not breach your contract. Most importantly, these actions are turning up the pressure on the Government to do the right thing for patients and general practice. We are the bedrock of the NHS, but our services have been driven to near collapse.

We need you to take action to protect our patients and protect our practices.  

Focus on action – serving notice on voluntary services

We are producing more guidance around individual collective actions to support those practices in undertaking specific actions. This week we are focusing on serving notice on voluntary services.

Watch our two minute collective action video on unfunded work which shows GPCE colleagues’ views on this specific collective action. We are asking you to consider serving notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of your patients, practice and staff. We recommend liaising with your LMC for advice around communications and notice periods required (if any), around the cessation of these services, or alternatively contacting info.gpc@bma.org.uk for further information and advice. 

Our GP campaign page has more information about all of the actions. Please also refer to our Safe Working Guidance Handbook and other useful links such as guidance for GP collective actionbackground to the 24/25 contract changes, and infographics that can be displayed in practices. 

If you wish to receive data about action taken by practices in your LMC area, please complete this form and we will contact you. Please note that the level of information we are able to provide will depend on the overall response rate in the area. 

Please do not hesitate to contact Aarti Gokal, GP Campaign Coordinator (agokal@bma.org.uk) if you have questions regarding the survey.

Collective action tracker survey

The October action tracker survey was published on Monday 14 October and will close at 5pm on Sunday 20 October. Please share this link with your practice managers/GP partners and encourage them to fill in the survey. We need this data to monitor participation across the country. In turn, we can drive up our demand to Government for a new contract that is fit for purpose, with the investment and workforce needed to reset general practice and bring back the family doctor.  

GP Additional Roles Reimbursement Scheme (ARRS)

The updated PCN DES bringing in the GP ARRS was released last week. GPs employed via the Scheme must be within 2 years of their CCT on 1/10/24 and PCNs will be required to provide terms no less favourable than the BMA salaried GP model contract, in line with the GMS/PMS contract.  

GPC England and the Sessional GPs Committee have released guidance for PCNs, and individuals employed under this scheme. It can be found here

Whilst there is progress in acknowledging the difficulties currently faced by many GPs struggling to find jobs, we continue to stress to NHSE and the Department of Health the underlying issue of GP unemployment and how this needs to be better addressed through additional support and funding at a practice level, reinforcing the need for a new GP contract to support this.

Read the blog by Dr Mark Steggles, Chair, Sessional GPs Committee


GPs vote in favour of phasing out physician associate role in general practice

Following the publication of the GPC England and RCGP guidance on the role of physician associates, the GPs Committee UK (GPC UK) met yesterday and discussed the role and safety of physician associates in general practice. The committee overwhelmingly voted in favour of the motion below: 

This meeting believes that the role of physician associates in general practice is fundamentally unsafe and:

  1. there should be no new appointments of physician associates in general practice
  2. the role of physician associates in general practice should be phased out
  3. the role of a physician associate is inadequately trained to manage undifferentiated patients, and there should be an immediate moratorium on such sessions.

The BMA believes that those in existing physician associate roles should be given opportunities to retrain into more suitable NHS roles, including the appropriate undergraduate and postgraduate training in medicine. 

The priority needs to be the recruitment and retention of more GPs into the workforce. We want to be able to give patients the care and services they need, when they need them, with the most appropriate clinician. The Government must urgently invest in practice staff such as GPs and general practice nurses.

Read the full press statement here

BMA legal action on MAPs

The BMA is to financially back a legal challenge against the GMC over its failure to distinguish between doctors and PAs (physician associates). 

Campaign group Anaesthetists United has been joined by the parents of 30-year-old Emily Chesterton, who died after seeing a PA who she thought was a GP, in their legal action. Together, they allege that the GMC has not enforced a national scope of practice for MAPs (medical associate professionals) after they graduate, which they argue represents an unlawful failure in the GMC’s duty to properly regulate the clinical practice of these associate professions in the UK. 

This follows legal proceedings started by the BMA against the GMC in June on the GMC’s decision to use Good Medical Practice for PAs and AAs rather than creating specific standards for those professions, and the GMC’s use of the term ‘medical professionals’ for PAs and AAs.

Use of patient data for research

Following the Health Secretary’s speech at the RCGP Conference, where it was stated that NHS England would take care of primary care data for research, where patients had consented for it to be used in studies, Dr David Wrigley (GPC England Deputy Chair and IT lead) commented:

“Research is fundamental to improving public health, and the BMA has been in conversation with NHS England, the Government, and relevant research organisations about how to safely make the data of those patients who have given explicit consent available for this use. 

“We are pleased Government will thoroughly review the consent processes used by these research organisations and will take full responsibility for the safe and proper onward sharing of that data which originates from the GP record. We have made it clear that the agreement is strictly limited to circumstances where patients have given - and continue to give - their informed consent to the sharing of their medical record.

“Patient data is incredibly valuable, and we are pleased to see the Government has also committed to ensuring the highest security arrangements for its protection and appropriate use.”

GP contract changes and implementation

Here is a reminder of what has been uplifted from this month: Global sum has been uplifted to £112.50 per weighted patient for GP practices to implement the DDRB uplift. Locum reimbursement rates have increased, along with the pay elements of workforce-related transformational funding. 

From 1 October, newly qualified GPs can be recruited as part of the additional roles reimbursement scheme (ARRS) and PCNs can request the funding as outlined in the updated PCN contract DES. In addition, three other PCN funding streams have been increased to reflect the DDRB uplift: core PCN support, the care home premium service and the enhanced access service.  The maximum reimbursement rates for existing ARRS staff have been uplifted with effect from 1 October to align with Agenda for Change pay scale uplifts. 

Medical Academic Staff committee (MASC) election for academic GP

The BMA’s Medical Academic Staff committee is currently seeking your nomination for the following position:

  • One female GP Academic or public health clinical academic elected by and from among academics in England 

MASC represents all medically qualified teachers and research workers that hold contracts of employment (including honorary contracts) with a university, a medical school, or other non-NHS institutions engaged in medical education and research. MASC advocates on behalf of academic medicine and works with employers to ensure that there are sufficient incentives to attract doctors to (and keep them in) academic medicine. Find more information about the work of the committee here.

Nominations closes at 12pm 24 October 2024, with voting taking place between 2pm on 24 October and 2pm on 31 October 2024. If you would like to nominate yourself, please go to https://elections.bma.org.uk/   

If you have any questions or require assistance, please contact elections@bma.org.uk.

Read more about the work of GPC England and practical guidance for GP practices

See the latest update on X @BMA_GP and read about BMA in the media

Contact us: info.GPC@bma.org.uk

Read the latest GPCE bulletinGP opinion survey | Patients First: our vision | unfunded work | your practice’s action

Read the latest Sessional GPs newsletter

GP Action 

The GPs Committee England met last week where we discussed the next steps of GP collective action as part of our ‘Protect your Patients and Protect your Practice‘ campaign and other upcoming issues affecting general practice. 

We would encourage practices to continue to take action using our safe sustainable action menu. It is up to each practice to choose which actions to take, and whether to do one, or many. None of them represent a breach of your contract, but they will help you manage your workload and keep you and your patients safe. Your LMC will also provide you with additional advice, tailored to local arrangements. 

Our GP practice survival toolkit provides for a menu of actions you can choose from, to support a safer delivery of services for patients and practice team:

  • Limit daily patient contacts per clinician to the UEMO recommended safe maximum of 25
  • Serving notice on voluntary services that plug local commissioning gaps
  • Cost up the value of providing locally commissioned services and serve notice on contracts which are undermining practices’ ability to sustain a service
  • Withdraw permission from secondary-use data sharing agreements 
  • Freeze sign-up to new data sharing platforms
  • Stop engaging with the e-Referral Advice & Guidance pathway
  • Stop rationing referrals, investigations, and admissions
  • Switch off GP Connect Update Record Functionality
  • Ignore medicine optimisation software which diminishes patient choice in return for system savings never seen by GP practices 
  • Defer your PCN declaration regarding online triage to 2025

We are urging the Government to engage constructively with us as soon as possible to determine short, medium, and long-term solutions to save General Practice.

Find out more here

Watch GPs talking about the actions they're taking >

GP Additional Roles Reimbursement Scheme (ARRS)

The updated PCN DES bringing in the GP ARRS was released last week. Pay for these roles will be set at the lowest level of the DDRB recommended sessional pay range, with PCNs able to claim up to £92,462 (including on costs), together with London weighting if applicable. The funding available to PCNs to fund these roles will be £1,303 multiplied by the PCN Contractor Weighted Population on 1 January 2024. The GP in ARRS allocation is separate to the pre-existing ARRS allocation, and PCNs cannot cross-subsidise between the two funding streams 

GPs employed via the Scheme must be within 2 years of their CCT on 1/10/24 and PCNs will be required to provide terms no less favourable than the BMA salaried GP model contract, in line with the GMS/PMS contract.  There are, however, no requirements on how these GPs should be utilised within the PCN.  GPC England and the Sessional GPs Committee will be releasing guidance for PCNs, and individuals employed under this scheme, shortly.

Whilst there is progress in acknowledging the difficulties currently faced by many GPs struggling to find jobs, we continue to stress to NHSE and the DHSC the underlying issue of GP unemployment and how this needs to be better addressed through additional support and funding at a practice level. 

Safe working guidance

Last month we published a safe working guidance handbook  safe working guidance handbookto help GPs and practices in the delivery of safe, high-quality care for their patients and communities. The profession wants to provide care without risk to patients or ourselves. The handbook embeds and prioritises safe high-quality care for your patients by focusing on the delivery of prioritised core GP services. These actions will work, and will build growing leverage in the months ahead to support us in negotiations for you and your practice team. 

Read more on Safe working, including social media graphics and a poster.

Shortages of doctors and patient increase – BBC analysis

BBC analysis of NHS data has shown that the average GP in England has to care for 17% more patients than nine years ago. The areas struggling the most have more than 3,000 patients, nearly double those with the most doctors.The government said it was developing plans to train more doctors and relieve some of the pressure by giving pharmacists more responsibilities.

The GPCE Chair, Dr Katie Bramall-Stainer said these figures lay bare the realities of the workforce crisis in general practice and demonstrate how practices have been expected to keep doing more for less. This has led to the closure of 2,000 GP practices since 2010. General practice is collapsing. Rather than giving pharmacists more responsibility, patients want more GPs and we agree with them.  

Labour party conference update

Last week GPCE Officers attended the Labour Party Conference. The NHS, and particularly general practice, was a key conference topic, alongside the Darzi Review and the NHS ten-year plan, anticipated for release next spring. Dr Katie Bramall-Stainer and Dr Samira Anane met with a number of MPs including Minister of State for Care, Stephen Kinnock, PPS to Wes Streeting, Mr Zubir Ahmed, Dr Simon Opher, Dr Beccy Cooper, Leigh Ingham, Nesil Caliskan and Josh Dean. Dr Bramall-Stainer also spoke at the BMA’s roundtable attended by a number of MPs. During these meetings GPCE outlined our upcoming strategy for the new Government; our priorities and our recommendations to urgently address the crisis in general practice and GP unemployment. 

GP pressures: latest workforce and appointment data

GPs continue to treat many more patients than they have done in the past. The latest data shows a record 63.47 million patients registered with practices in England, while there are over 1,000 fewer GPs compared to 2015.

As a result, each full-time equivalent GP is now responsible for an average of 2,282 patients, 345 (or 18%) more than in 2015, and appointments level at an average of almost 1.5 million per day. All of this puts staff at your GP surgery under immense strain, with knock-on effects for patients. 

Learn more about the pressures on general practice

RCGP changes position on physician associates

At its September UK Council meeting, the RCGP voted to oppose a role for physician associates in general practice, with 61% of members voting for the change of position. However, the college will still be pushing ahead with planned guidance development given the pe-existing presence of PAs in general practice. The RCGP also voted to expunge a paragraph from their draft scope of practice guidance which would have exempted PAs already working in general practice from the scope limits. The college now plan further work on this guidance before publication.

GPC UK recently published the guidance Physician associates in general practice: making it safe for patients and GPs and will be discussing the RCGP’s change in position at its next meeting on 17 October.

New dispensing feescales

The new dispensing feescales for England and Wales, effective from 1st October 2024, have been published, showing a reduction in the average dispensing fee to 218.7p per item (average), a decrease of 0.2p compared with April 2024. This reduction is based on a new methodology designed to further smooth out the fluctuations seen in the previous biannual fee adjustments.

Dispensing fees are intended to cover the costs of running a dispensary, including staff expenses. However, from April 2025, the average fee is set to reduce further by 5.37p per item (on average) to 213.3p (compared to the October 2024 rate). This continued downward trend may prove to be a tipping point for some dispensing practices, as the cumulative impact of underfunding in rural practices takes its toll. GPC England continues to work closely with the Dispensing Doctors Association; both organisations recognise and promote the value of dispensing practices to their patients and within their communities.

LMC Secretaries Conference 2025 – Save the date

The LMC Secretaries Conference will be taking place on Friday 7 February 2025, in London, BMA House. Registration details will be sent out in coming weeks. If you require any further assistance, please contact us through info.lmcconference@bma.org.uk

Read the latest bulletinTake action to save general practice | GP ARRS update | safe working guidance

GP Action 

Now that summer is over and we know you’re keen to get stuck into Collective Action. We have given the new government an opportunity to get around the table, but we are still waiting to hear back. I’ll be at the Labour Party Conference this weekend, and I’ve written to the Secretary of State this week ahead of the Autumn financial statement next month: the clock is ticking. 

Over 80% of practices are already taking one or more actions from our safe sustainable action menu. None of them breach your contract, but they will help you manage your workload and keep you safe. Don’t forget to use our safe working guidance handbook to support your practice team’s transition to providing safer, higher quality care for the patients you see.

Our GP practice survival toolkit include 10 actions practices can choose from, to support a safer service for their patients and their practice team, including:

  • Taking steps towards limiting daily patient contacts per clinician to the UEMO recommended safe maximum of 25
  • Serving notice on additional unfunded work outside your contract, or on poorly funded locally commissioned services which are draining practice resource
  • Opting out of local secondary use data sharing agreements
  • Switching off or muting medicine optimisation software which cuts costs as a priority over quality prescribing
  • Deferring your PCN declarations regarding online triage to 2025

Our new safe working guidance handbook embeds and prioritises safe high-quality care for your patients by focusing on the delivery of prioritising core GP services. These actions will work and build growing leverage in the months ahead to support us in negotiations for you and your practice team. 

GP action tracker

GPs and practice teams have never been more unified by our desire to protect our patients, practices, and safeguard our collective future. Taking action won’t breach the GP contract but will show local health systems and NHS England our strength of feeling. The time to act is now.

Let us know what actions your practice is taking for September’s snapshot through our monthly action tracker so we can build heat maps and see all our efforts combined across the 42 ICBs (closing this Sunday 22 September).

GP 2024 Practice Finance Survey – now closing TODAY (20 September)

The annual practice finance survey is a key element of our evidence in negotiating our collective asks demonstrating the current, contemporaneous financial pressures on practices. Please share the survey link with your practice manager or finance lead partner this afternoon and submit what you can!

The recent DDRB uplifts have resulted in a 1p rise per patient per day – this is still woefully insufficient to stabilise practices which are collapsing. Help us to help you: www.research.net/r/H9CYXCP

Darzi Review

Last week saw the publication of the Darzi Review which was commissioned by Health Secretary, Wes Streeting to undertake a rapid investigation of the state of the NHS, assessing patient access, quality of care and the overall performance of the health system. The BMA has been clear in our response that the review echoes many of our own concerns and recommendations.  The review noted that: 

"Engaging with doctors is essential, valuing the staff tasked with resuscitating the NHS is critical, but an honest conversation with the public about what money goes where, what will and will not be provided, and what will be rationed until additional resources are made available, is imperative."

The BMA made several submissions to the Review itself highlighting four areas which must be prioritised by the Government in its efforts to deliver a new 10-year plan for the NHS. These include access to healthcare, increasing workforce capacity in primary and secondary care, improving public health and boosting NHS finance, capital and productivity. These are areas we think warrant immediate attention if the Government is serious about starting to rebuild the damage done to the NHS over the past decade.

spoke on Times radio saying that the NHS recovery plan and growing primary care as a proportion of the NHS budget, could be ‘music to my ears, as a GP’. ‘A lot of the messages are ones we have been calling for’. However as Katie also said on BBC Radio 4’s Today programme last Friday 13 September, general practice cannot wait for prolonged Government plans and papers next year – general practice is collapsing now, which is why we have no choice but to take collective action now to prevent the loss of more GP surgeries and the loss of experienced GPs from the NHS workforce.

Liberal Democrat Party Conference 

I also attended events and meetings at this year’s Liberal Democrat conference with GPCE contracts and regulations policy lead, Dr James Booth. The aim was to secure awareness and support for our key asks of government. Events included an NHS Providers roundtable with key health stakeholders chaired by The Guardian’s senior health correspondent, Denis Campbell, and meetings with a new MPs, Tom Gordon, Pippa Heylings, Tom Morrison, Ian Sollom, Freddie Van Mierlo, Will Forster and Clive Jones. 

Your GPC England representatives outlined current pressures facing general practice, our exceptional mandate to take action, GPCE asks of government, including additional funding and a new contract, and what our next steps will be. The meetings were productive with MPs gaining a greater understanding of the current situation and offering their support in addressing our concerns with the Government.

Rollout of the medical examiner system in England 

In England, the statutory implementation of the medical examiner system has taken place.

Independent scrutiny by a medical examiner is now a statutory requirement prior to the registration of all non-coronial deaths. Information from the Department of Health and Social Care is here

If you require further information on implementation in your area, please contact your LMC. For more wider information on the medical examiner system please contact the BMA

DDRB Report 2024/25: Implications for General Practice

The Government accepted the recommendations of the 52nd DDRB (Doctors and Dentists Pay Review Body) Report, and for the first time since 2018/19 the DDRB made recommendations in relation to both GP contractors / partners and salaried colleagues. NHS England/DHSC have now finalised how the DDRB Award of 6% for Contractors will be implemented, and practices should receive backdated sums to April 2024 in this month’s pay run from ICBs.

The aggregate rise in the 2024/25 GS (Global Sum) payment per weighted patient will be 7.4% resulting in a new GS payment per weighted patient of £112.50 – an increase of £7.77 compared to 2023/24. The OOHs deduction remains at 4.75% and in absolute terms this will change from £4.97 to £5.34, aligning with the total uplift of 7.4%.

The value of each QOF point in 2024/25 will therefore be £220.62 compared with £213.43 in 2023/24 (an increase of 3.4%). The DDRB has also recommended a 6% increase to GP sessional colleagues’ salary scales from 1 April 2024. GPC England has drafted a Focus On document which includes:

  • what uplift the DDRB has recommended this year
  • the mechanisms used to apply it to the Global Sum
  • how this affects the Global Sum payment per weighted patient and 
  • why not every practice always gets enough to pass on the full pay uplift to their practice-employed staff. 

Our focus on document is also available on the BMA website.

Reviewing LMC Listserver

We are reviewing the LMC listserver to ensure that only current and relevant officers of LMCs are registered on it. We would be grateful if you could let us know who should be on the listserver on behalf of your LMC, eg office email and/or medical secretary, name, role, email address, to kday@bma.org.uk by 30 September 2024.  Those that are on the listserver but not on your lists will be removed.

Read more about the work of GPC England and practical guidance for GP practices

See the latest update on X @BMA_GP and read about BMA in the media

Contact us: info.GPC@bma.org.uk

Read the latest GPCE bulletinGP collective action | Darzi review | Liberal Democrats Party conference


Launch of BMA GP Safe
 Working Guidance Handbook

Following the overwhelming YES vote in our ballot over the summer, practices are starting to take action as part of our ‘Protect your Patients and Protect your Practice‘ campaign.

GPC England have published a ‘Safe working guidance’ handbook to help GPs and practices in the delivery of safe, high-quality care for their patients and communities. The profession wants to provide care without risking harm to others or ourselves. 

At a time of unprecedented pressures, we must make changes to our workload to preserve patient care in the face of a shrinking workforce and rising demand. This will help to protect the sustainability and future of general practice.

We recommend you do this by focusing on the delivery of General Medical Services, in line with the needs of your patients and practice, and deprioritising work and activities that fall outside of your core contractual requirements. This guidance reflects the contractual changes imposed by NHS England in April 2024. We offer ways of doing this that still enable you to stay within the terms of your GMS/PMS.

The guidance outlines how to manage workload effectively, setting safe limits of 25 patient consultations per day in line with UEMO recommendations, and encouraging practices to adopt systems that protect both patients and staff. 

The BMA handbook can be downloaded and saved from the website:  www.bma.org.uk/GPsSafeWorking.

Further guidance and resources such webinars and FAQs can also be accessed, with patient information posters and social media graphics to download and share.

We cannot care for our patients if we do not care for ourselves and our colleagues.

Manage workload to protect your patients and protect your practice.

Practice Finance Survey – DEADLINE MIDDAY 17 SEPTEMBER

We are inviting practices in England to complete our Practice Finance survey, to build evidence for us to support the annual contract negotiations. This is your opportunity to feed into an evidence base demonstrating the impact of inflation and rising cost over the last couple of years, on GP practices.

Please share the survey link with your practice manager colleagues so that they can complete the survey. The survey will close at 9am, Tuesday 17 September.  

We recommend that respondents have relevant information to hand before starting the survey: they will need GP practice accounts for 2022/23 and 2023/24, expenditure data for April 2023 and April 2024, and information on staff numbers and practice list size. Take the survey

ACTION TO SAVE GENERAL PRACTICE

Following the overwhelming YES vote in our ballot over the summer, practices are starting to take action. Each action is safe, effective, sustainable and clear, and it is up to each practice to choose which actions to take. We would encourage you to find out more about how to take part in the toolkit menu on the BMA website. Your LMC will also provide you with additional advice, tailored to local arrangements.

Visit our GP campaign page for more information about taking part in the campaign, the actions and how to order campaign materials and patient resources.

Please note that most campaign resources are back in stock, with more lanyards being available very soon. If you are ordering for a wider group of people or practices, please make sure you are not double ordering.

Read the guidance for salaried GPs and locum GPs during collective action and the collective action FAQs for GP Registrars

Action tracker survey

We are gathering data on any actions that practices across England are taking, and from 16 September, surveys will be sent monthly. We will share the survey with LMCs to distribute to practices and we will be contacting partner members directly to ask you to input data per practice. 

We want to hear about the actions you are doing, or considering so please do reply when you receive the survey during the week commencing 16 September. Responses from practices helps us to monitor how collective action is progressing across the country, supporting our negotiations and work towards a GP contract that is fit for purpose.  The data is just for us and will not be shared outside of the BMA.

GPCE view on request for Cloud Based Telephony data

As part of the 2024/25 contract imposed on the profession in April, NHS England (NHSE) have sought directions from the Secretary of State to extract data from our clinical systems on our Cloud Based Telephony (CBT) usage. An email has been sent by NHSE outlining the instructions to comply with this data extraction under section 259 (1) (a) of the Health and Social Care Act 2012, stating:

All general practices are therefore mandated to comply with this invitation and approve the collection.’

The legal basis for the collection is explained in the Data Provision Notice, which will enable your call data to be extracted on a monthly basis. 

The BMA has taken its own legal advice: 

Practices cannot decline the instructions, as doing so will risk breaching their contract

We have made it clear to NHSE that the data must not be used to performance manage practices or single them out for criticism. 

The PCN DES includes three components of the Capacity and Access Improvement Payment (CAIP). This data extraction is the component pertaining to the existing use of CBT and the relevant metrics. GPCE advice is that should a practice fail to sign up ahead of the October 1st deadline, there may be a risk of a breach notice being imposed as well as contravening the Health and Social Care Act 2012.

There is another component which relates to ask No 9 in our collective action campaign. We have significant concerns around online consultation software being available to patients from 08:00-18:30 given practices’ lack of capacity, and their responsibilities for ensuing patient safety. 

GPCE advice continues to apply here: CDs and PCNs are advised not to sign this particular declaration presently, but to await further guidance closer to the financial year end. 

Read the full update here and if you have any queries, please email us at info.gpc@bma.org.uk

Rollout of the medical examiner system in England 

In England, the statutory implementation of the medical examiner system will take place on 9 September 2024. This will mean that independent scrutiny by a medical examiner will become a statutory requirement prior to the registration of all non-coronial deaths from this date. Information from the Department of Health and Social Care is here

While many are using the medical examiner system, some are not. If you require further information on implementation in your area, please contact your LMC. For more wider information on the medical examiner system please contact the BMA

Zero tolerance of racism: download our poster

Last month’s racist, Islamophobic and anti-migrant riots were hugely distressing with wide reaching impact felt across healthcare settings and communities. All healthcare workers have a right to work in an environment free from abuse.  Patients need to be warned that there will be zero tolerance of racist behaviour with resultant consequences, should this not be respected. We have produced a poster you can print and display in your premises, making it clear that racist abuse will not be tolerated. 

You can also contact the BMA for wellbeing and support, and we have guidance for managing discrimination from patients, with clear steps to take when incidents of racist abuse against healthcare staff occur.  

GP pension campaign in England

At the end of July, the BMA’s pensions committee launched a campaign to assist GPs in England to get their pension records up to date. There is a step-by-step guide for members to follow, with pre-populated email templates to assist. It is important to ensure that your record is as accurate as possible so you can make appropriate decisions about your pension and the McCloud remedy. 

If you have received your 05 and AA statement from NHS Pensions, and your record is not updated to 2022-23, you can check what years are missing from your record by logging into your PCSE Pensions Online account. As the Pensions Online system is updated in sequential order, you will be able to see which type 1 or type 2 form is holding up your record from being up to date. You can then submit the required forms via your online account or through the online form.

If you have submitted all required forms and your record is still not up to date, you should raise a complaint with PCSE. If it not fully resolved within 40 days - follow the escalation process

Successful RCGP legal challenge in support of disabled doctors

The BMA has won a legal challenge supporting a trainee GP who believed they had been unfairly treated by the RCGP because of its policy on the number of attempts at taking an exam. ​The BMA supported the doctor to bring judicial review proceedings challenging the lawfulness of the RCGP’s attempts policy, which only allows four attempts at the AKT/RCA exam required to complete GP training. According to the policy, no additional attempts would be granted, even in circumstances where a candidate discovered, after sitting a test, that they had a disability which would have entitled them to “reasonable adjustments”, including additional time for the taking of the test. 

BMA sessional GP conference 2024: diversity, opportunity, safety

The BMA sessional GPs conference takes place on 20 September 9:30am - 4:30pm. It's free for members, but non-members can also attend. This event will give you information on topical issues including future models of general practice and establishing professional relationships with new clinical roles such as ARRS staff and PAs. Breakout groups will provide practical advice and guidance on a choice of topics in smaller groups. Check out all the details of the day and register your place

Conference of England LMCs 2024
The Conference of England LMCs 2024 will be held on Friday 22 November at Friend’s House, 173-177 Euston Road, London SW1 2BJThe deadline to submit motions is noon, Wednesday 11 September 2024. The motions should be submitteed via the BMA website using this link (further instructions were sent on 10 July). The deadline for registration is noon Friday 1 November. Register here

Reviewing LMC Listserver 

We are reviewing the LMC listserver to ensure that only current and relevant officers of LMCs are registered on it. We would be grateful if you could let us know who should be on the listserver on behalf of your LMC, eg office email and/or medical secretary, name, role, email address, to kday@bma.org.uk by 30 September 2024.  Those that are on the listserver but not on your lists will be removed.

Read more about the work of GPC Englend and practical guidance for GP practices

See the latest update on X @BMA_GP and read about BMA in the media

Contact us: info.GPC@bma.org.uk

Read the latest GPCE bulletinSafe working guidance handbook launch | practice finance survey | taking action to save general practice


 

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