How 'catastrophic' GP work-to-rule disruption will affect you (2024)

GPs have voted to take major industrial action from today onwards which aims to bring the NHS 'to a standstill' and that experts warn 'will hit patients' hard.

More than 8,500 family doctors in England took part in the British Medical Association (BMA) ballot, with 98.3 per cent backing the mass action.

It meansGPs, who earn up to £700,000 according to NHS data, could slash the number of daily appointments held in England by a third.

Family doctors have warned their industrial action could last for 'months'.

So what does this mean for your GP appointments? How have the Government responded? What other parts of the NHS will be affected and how?

Here MailOnline explains everything you need to know about the upcoming action.

What does this mean for my appointment?

GPs are now being asked to take part in up to 10 forms of protest, including one which would put a cap on the number of daily 'patient contacts'.

This includes face-to-face appointments, remote consultations and online messages.

Under recommendations implemented by the BMA and European Union of General Practitioners, GPs should not deliver more than 25 appointments a day to ensure 'safe care'.

Patients over the cap would be diverted to 'local urgent care settings' such as 111 or walk-in clinics when the total is hit.

As many as 3million GP appointments a month could disappear if family doctors push ahead with the plans, according to estimates by primary care leaders.

ButGP practices are still required to open from 8am to 6.30pm Monday to Friday during collective action.

NHS England has urged patients to come forward for care as usual.

The appointment cap comes, in part, because some family doctors are reportedly overwhelmed by patient demand.

Some have reported having to cram in nearly 90 patients a day in 'conveyor belt' style appointments which senior family doctors say is unsafe for patients. The average number of daily appointments per GP currently stands around 37.

Other measures included in the industrial action include refusing to co-operate with standard NHS systems, such as those used to refer patients to hospital specialists or to share data with local health planners.

Earlier this week,Dr Bramall-Stainer said the action aimed to 'bring the NHS to a standstill very quickly'.

However, she insisted: 'It is industrial action, but the target isn't patients. The target is NHS England [and the] Department of Health.'

BMA leaders have said the measures will remain in place until ministers agree to a new GP contract.

Is the action about pay?

Yes and no.

Family doctors across England were balloted amid a row over the new funding contract for GP services.

According to the data from NHS Digital average GP pay, across all levels, hit £118,100 in 2021/22.

This data set includes figures for GP partners as well as the family doctors employed to provide services.

GP partners in England — those own their own practice and make up the majority of family doctors — pocket an average of £153,400 a year.

For comparison, the average pay for salaried GPs was £68,000. This is up from £64,900 in 2020/21 and £63,600 in 2019/20.

But a freedom of information request to NHS Business Services Authority also showed in 2023 at least one GP in England pocketed a pensionable salary of over £700,000.

The medic is likely to be benefiting from a contract that allows them to run several surgeries and earn money for providing extra treatments.

Six also earned between £250,000 to £300,000, with 32 recording salaries of between £200,000 to £250,000.

So why are GPs taking action?

The union say GP funding is being squeezed and the terms of a newNHScontract— a 1.9 per cent funding rise for 2024/25 — means 'many surgeries will struggle to stay financially viable'.

GP surgeries have also faced rising levels of harassment, assaults and verbal abuse targeted at staff in recent months.

Doctors have been told they can 'pick and choose' from measures designed to wreak chaos across the health service.

Announcing the ballot result today, Dr Katie Bramall-Stainer, chairman of the BMA's GP committee said GPs are 'at the end of their tether'.

She added:'We have no choice but to move ahead with collective action to protect our practices, and our patients.

'This will not be a "big bang". It will be a slow burn. It's likely that impact may not be felt for some time.

'We hope this will give the new Government time to consider our proposed solutions including fixing our contract once and for all.

'General practice should be the front door of the NHS, not the doormat.

'We don't want to have to take this next step but must if we're to stop our services from collapsing completely.

Family doctorslaunched a formal dispute over the issue in April after a referendum carried out by the BMA saw 99 per cent of 19,000 GPs rejected the contract.

But patients' groups have already said the plans are 'selfish' and GPs risk losing the support of the public in an attempt to argue against contracts which are already generous.

Why is it difficult to access an appointment?

There are now more than 950,000 GP appointments on average in England every day — an increase of more than 40,000 since 2018/19.

But despite this undeniable rise in demand, the number of GPs working in the NHS has actually stagnated.

Increasing numbers of doctors are reducing their working hours and retiring early.

Some are leaving for the private sector or abroad because of the soaring pressures.

While the number of NHS consultants growing by 18 per cent between 2016/17 and 2021/22, the number of GPs has only increased by just four per cent over the same period.

Nationally, therewere 27,487 fully qualified, full-time equivalent GPsworking in England in December, equating to one GP for every 2,078 patients, on average.

Health chiefs say the ratio of patients to every one fully qualified GP should never exceed 1,800.

The ratio is widely recognised by local medical committees — local representative committees of NHS GPs — as the 'safe limit'.

The Office for National Statistics projects there will be an extra 6.6million people living in the UK as of 2036.

Assuming this growth kept in line with current demographic trends, this would see England's population hit 62.2million.

Under this figure, 34,000 GPs would have to be working in the NHS to meet the one per 1,800 patient ratio, meaning an additional 7,000 family doctor positions are required over the next 12 years.

Have GPs taken industrial action before?

GPs have not staged collective action since 1964 when family doctors handed in undated resignations to Harold Wilson's Labour government.

A proportion of GPs, however, staged industrial action in 2012 in protest against increases in pension contributions and a later retirement age for doctors.

Estimates suggest between a fifth to a third of practices took part in the action.

It's currently unclear how many GP practices will take part in the current action.

How has the Government responded?

Commenting before the ballot result was published Health Secretary Wes Streetinginsisted any collective action 'will only punish patients'.

Also to the announcement, the Government today announced it hadadded GPs to the additional roles reimbursem*nt scheme (ARRS), in the hope practices will be able to hire 1,000 more doctors this year.

The ARRS scheme was introduced in 2019 and lets primary care networks, groups of GP surgeries operating in the same area, hire for other roles such as podiatrists and occupational therapists and claim reimbursem*nt for their salaries.

Mr Streeting added £82million to the £1.4billion ARRS pot to fund what he described as an ’emergency measure’.

The expansion of the scheme aims to allow practices to hire 'newly-qualified GPs' who face potential unemployment this summer.

This announcement follows the Government’s commitment earlier this week to increase GP pay by 6 per cent, following the doctors' pay review body recommendation.

But senior medics claimed the uplift did not go far 'enough to address the erosion' of GP funding.

Labour's election manifesto carried no promises of increased investment in general practice, but in his previous role as shadow health secretary, Mr Streeting had claimed that GPs have 'a lot to look forward to' under a Labour Government.

Why is patient satisfaction with GPs currently so low?

Patient satisfaction has, as a result of the never-ending appointments crisis, plunged to its lowest level in four decades.

According to the 2023 GP Patient Survey, a poll of759,000 Brits, just seven in ten (71.3 per cent) described their overall experience of their GP practice as 'good' overall.

Fewer than half of patients (49.8 per cent) said they find it easy to get through to their GP practice on the phone, down from 52.7 per cent in 2022 and 80.8 per cent in 2012.

And one in four people (24.2 per cent) said it was 'not at all easy' to get through, five-times higher than the 5.4 per cent in 2012.

Only one in six patients (16.4 per cent) were 'always or almost always' able to see their preferred family doctor, with 19.3 per cent saying they can 'never or almost never' see them.

Equally, patients have continually expressed frustration over a lack of face-to-face appointments.

Just over two thirds of all appointments on average are now held in person, compared to roughly 80 per cent pre-Covid.

Despite this, topdoctors have suggested the figure may never return to this level arguingpatients shouldn't get a face-to-face appointment if there is no clinical need for one.

Some campaign groups, however, have disagreed, warning that telephone or online calls are not appropriate for everyone and aren't always the best way of diagnosing patients.

Instead, disgruntled patients have abandoned NHS surgeries in favour of going private or visiting swamped A&E units instead.