Why are English GPs going on strike and what are the implications for patients?
GPs in England are to go on strike for the first time in 60 years over a funding dispute, with NHS England warning the action could cause significant disruption beyond primary care.
How did they get here and what are the implications for patients and the NHS?
Why do GPs take action?
More than 8,500 GPs took part in a British Medical Association (BMA) poll that closed on Monday and today it was announced that 98.3% voted in favour of industrial action.
The BMA says the new GP contract, in which the previous government only agreed to a 1.9% funding increase for 2024-2025, means many practices will struggle to remain financially viable.
GPs launched a formal dispute over the issue in April after a BMA referendum found 99% of the 19,000 GPs had rejected the contract.
What is collective action?
General practitioners did not vote for a strike or closure of their practices, but opted for a punctuality action.
The BMA recommends a list of 10 measures that GPs can take, with practices being able to choose how many they implement.
This may involve, for example, GPs limiting the number of patients they see per day to 25, choosing to no longer do work for which they are not formally employed and not sharing patient data unless this is in the best interests of the patient.
What are the implications of this for patients?
GP surgeries must still be open from 8am to 6.30pm Monday to Friday, but patients may find it harder to get an appointment. The level of disruption will vary between practices.
Louise Ansari, the director of Healthwatch England, said the work-to-regulation move could “exacerbate” access problems or “even put people off seeking help if they are unsure whether their practice is still open to patients”.
NHS England has urged patients to seek care as usual.
When does it start?
Immediately. Class action by GPs in England began on 1 August.
How long will the strikes last?
It could go on for months. Because it is a collective action, not a strike, the disruption could go on indefinitely.
Dr Katie Bramall-Stainer, chair of the BMA’s GP committee, has said it could take “week after week after week, month after month after month”.
When was the last time GPs took action?
This is the first time in sixty years that this has happened.
The last time GPs took collective action was in 1964, when GPs collectively submitted their undated resignations to the Wilson government. This led to reforms including the Family Doctor Charter of 1965.
Some GPs organised a strike in 2012 to protest against the increase in pension contributions and a higher retirement age for doctors. It is estimated that between a fifth and a third of practices took part in the action.
What are the implications of this for the NHS as a whole?
Experts warn that collective action is very likely to have wider health care implications.
NHS Providers, which represents NHS trusts, said the move would “hit patients hard as wider NHS services feel the knock-on effects”, while the King’s Fund think tank said the move could lead to thousands of people turning to services such as 111, pharmacies and emergency departments.
What did the government say?
Responding to the launch of the class action, Health Minister Wes Streeting said he wanted to build a “new relationship” with GPs.
In a letter to GPs posted on X, Streeting described general practice as the “heart” of the NHS but said it “has been neglected for too long”.
He wrote: “The (GP) contract needs to be reformed, but the relationship I want with you and the profession is not just a contractual relationship, but a new partnership.
“That is why I am determined to take immediate action in the interests of patients and address an immediate challenge that you have raised.”
What has the government offered?
Streeting has backed a recommended 6% above-inflation pay rise for GPs and their teams – a 4.1% increase in funding for GP contracts on top of the 1.9% rise. He has also announced plans to allow GP practices to use a separate £1.4bn scheme to recruit newly qualified GPs in 2024-25.
Will that be enough to end the feud?
Not likely. Collective action will continue until GP leaders and Streeting agree on a solution.