The British Medical Association has called for an immediate work-to-rule action by its members, who have complained of a lack of funding for general practice. The action will see GPs across England place a cap on the number of patients they are willing to see, with union guidance setting the limit at 25 per day. Some GPs currently see up to 40 patients per day. Over 98% of BMA members backed the action, which could lead to significant disruption to health services. Last month NHS England warned that such disruption would reach far beyond GP services, increasing waits and pressures on A&E departments, delaying patient discharge from hospitals and disrupting patient referrals.
GP practices are independent businesses, paid by the NHS to deliver care, and therefore are not directly employed. The BMA has laid out several options for GPs to take, although the final decision will rest with each individual practitioner. In addition to the limit on appointments, GPs could refuse to conduct pre- or post-treatment assessments, or risk ignoring guidelines which determine the allocation of treatments to priority patients.
The BMA believes that none of the suggested actions would place GPs in breach of their contracts. Patients’ rights groups have expressed concern that the action, if poorly communicated, could exacerbate difficulties that exist in accessing GPs and potentially deter some from seeking help altogether. Louise Ansari, Chief Executive of Healthwatch England, urged the parties involved to resolve the dispute as soon as possible, stating that patient welfare was “paramount”.
Approximately two-thirds of all GPs are BMA members. It is unclear how many will follow the work-to-rule action. While the NHS has announced measures to ensure the continued supply of necessary drugs, opposing comments from both the Royal College of General Practitioners and NHS England suggest that the dispute is unlikely to be resolved quickly. Increases in funding for primary care have been suggested as a means of resolving the dispute, however the government has thus far refused to accede to the demand
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