The BMA (British Medical Association) England GPs committee has rejected ‘insulting’ proposed changes to the GP contract in England which completely ignore the unsustainable and unsafe pressures practices are under right now.
With no additional investment to counter the damaging impact of soaring inflation on practice expenses – and to cover rising fuel bills and increasing staffing costs – GP leaders say this year’s offer from NHS England risks the safety of patients, brings the very future of practices into question and will cause even more GPs to leave when they are needed most.
The General Practitioners Committee (GPC) England members therefore voted to reject the changes at a meeting last week.
If the government and NHS England refuse to negotiate an improved offer, and a contract is imposed on practices, this would send entirely the wrong message to patients and a profession speaking up to defend patient safety
GPC England would therefore be forced to consider all options, including the potential for industrial or collective action.
Dr Kieran Sharrock, acting chair of the BMA’s England GP committee, said: ‘This year’s offer is a slap in the face of hardworking GPs and patients across the country.
‘To offer nothing to meet the spiralling costs of running practices as inflation runs rife, and teams continue to do more with less, is insulting to staff and unsafe for patients.
‘Last year, practices in England delivered 329 million appointments – 17 million more than in 2019, before the pandemic. Two-thirds of these were face-to-face and 85% took place within two weeks of booking.
‘Yet the government, via NHS England, continues to tell us we’re not working hard enough, and puts further unreachable targets and political soundbites ahead of safe, quality care.
‘With inflation remaining stubbornly high, burdening practices with rising expenses for bills, staff and services, this offer will lead partners to question the very viability of practices and their ability to continue trying to provide safe care to their patients.
‘When we’ve lost more than 400 practices in England since 2019, impacting millions of patients, we cannot afford to lose any more.
‘The biggest crisis facing general practice, staff and patients is the steeply declining workforce. GPs are leaving in their droves – with the equivalent of almost 2,000 full-time family doctors having gone since 2015, more than 400 in the last year alone.
‘For many undecided GPs, this insulting offer will likely be the final straw in pushing them out the surgery door.
‘In rejecting this offer we are standing up for both the future of the profession and the safe care of patients.
‘General practice can no longer be expected to take whatever is thrown at it. If there is no change in approach from this government, it will preside over the death of general practice as we know it.’
Meanwhile, poor health and wellbeing show junior doctors are not being valued, a new BMA survey reveals.
Seven in ten (71%) junior doctors in England have come to work despite not being well enough to perform their duties, in the last three months alone, the damning survey from the BMA has revealed.
New figures from the BMA’s latest survey of junior doctors in England show that more than three-quarters of respondents (78%) felt unwell as a result of work-related stress in the last year alone.
The vast majority of junior doctors (81%) who took part in the survey report that their health and wellbeing has worsened, or not improved, since December 2021 – when Covid-related pressures were pushing NHS staff and services to breaking point.
The findings come as the BMA is balloting junior doctors in England for strike action over their pay, which has been cut by 26.1% in real terms since 2008/09.
The union says that without fair pay, the NHS will lose doctors, resulting in longer waits for patients and even more pressure on the staff that remain.
In fact, around seven in ten (73%) junior doctors surveyed say they ‘always or frequently’ work in understaffed rotas, which may already be placing patient and staff safety at risk.
The continued decline in junior doctors’ wellbeing reflects the BMA’s longstanding concerns that hospital trusts in England are failing in their duty of care to junior doctors.
Trusts are also failing to provide some basic necessities such as proper rest facilities and hot food for junior doctors working out of hours.
More than a quarter of junior doctors (27%) said that they have no access to any form of rest facilities, while more than half (58%) do not have access to catering facilities with hot food.
Around half of junior doctors (51%) described their desire to work in the NHS in the next year as low or very low.
The doctors’ union fears that the mounting strain being placed on junior doctors will have a lasting impact on workforce numbers as doctors become increasingly burnt out and leave the NHS.
Dr Robert Laurenson and Dr Vivek Trivedi, BMA Junior Doctors Committee co-chairs, said: ‘This government needs to stop pretending that the pressures we’re seeing this winter isn’t a crisis of their own making.
‘Ministers have failed to step up and their failure to resource and staff the health service properly is not only threatening patient safety, but is also putting junior doctors’ health at serious risk.
‘No doctor deserves to work in horrendous conditions while not being valued or supported to do their job properly.
‘Continual devaluing of their lifesaving work will drive more junior doctors away, and the vicious cycle of staffing shortages will continue.
‘Until we restore our pay to restore our workforce, this will only get worse. The government needs to get real and get to the table to discuss.’
One junior doctor anonymously told the BMA: ‘I became a doctor to help people but the current state of the NHS is preventing staff like me from providing the standard of care we have been trained to give and that we think patients deserve.
‘When you’re covering so many patients in a day, hungry and with no breaks, you simply can’t do a good job by them.
‘The conditions we’re working in make it a daily battle to keep patients somewhat safe.
‘I have come into work when ill because I know my trust is understaffed and I want to keep patients safe.
‘Like so many of my colleagues, I do question whether it is worth staying in the NHS, as the current situation is totally unsustainable.’
The BMA survey of junior doctors in England was carried out between November and December 2022.
Part two of the survey focused on wellbeing, workload, culture and comparators, receiving 2,989 responses.
The survey asked 31 questions, including the following:?
On a scale of 1 to 5 (where 1 equals very low/negative and 5 equals very high/positive), how would you describe the current level of (2,766 responses)
Your morale:
- Very low/negative or low – 59.5% (1,645)
Your desire to work in the NHS in the next 12 months:
- Very low/negative or low – 51% (1,409)
For each of the following statements, please tick which option best applies:
(2,661 responses)?
Catering facilities with hot food are available to me when working out of hours:
- 57.8% (1,538)
- Yes – 9.6% (256)
Rest facilities are available to me when working out of hours:
- No or partly/insufficient – 64.7% (1,721)
Designated parking spaces are available for on-call shifts:
• No – 54.9% (1,461)
- Yes – 13.5% (358)
During your working hours in the last month, how often were you able to take your breaks in full? (2,690 responses)?
- Never or rarely able to take breaks – 38.1% (1,025)
- Always – 5.8% (156)
Thinking about your current placement, how frequently are there rota gaps for the rotas you are working (or other rotas you locum for?) (2,649 responses)
• Always or frequently – 72.9% (1,931)
In the last 12 months, have you felt unwell as a result of work related stress? (2,762 responses)?
- Yes – 77.7% (2,145)
In the last 3 months, have you ever come to work despite not being well enough to perform your duties? (2,764 responses)
• Yes – 71% (1,963)
The BMA is currently balloting its junior doctor members in England over strike action.
