Primary Care Collective Action – Notice to Patients

Posted on August 14th, 2024

You will be aware of the recent announcement of Collective Action being proposed by the British Medical Association (BMA) in support of the concerns of the ongoing and proposed level of funding to Primary Care GP Practices, which is degrading our ability to provide safe and effective care to our patients. General Practice appointments far outweigh appointments/contacts in other areas of the NHS, but only 8.4% of the NHS Budget goes to GP Practices.

With an ageing population, however, change is required for the future.  There is insufficient capacity in our system to keep undertaking work that we are not being resourced for.

GP Practices are independent contractors delivering patient care to the NHS. The 10 actions proposed by the BMA ensure that contractual obligations are fully maintained. It is then a decision for the Partners of each individual GP practice to decide which (if any) of these actions to act upon.

Essentially the proposal for the Collective Action is to push non-contractual work undertaken back to those who are already funded to undertake it, and to ensure the number of patients seen is at a safe level for both the clinician and the patient.

For Rothschild House Group’s patients we believe that the systems we have introduced over the past few years provide safe and effective care, but that an aging population and higher overall costs is putting significant additional pressures on us.

We are open for business as normal and have no plans to reduce availability or the number of appointments.

We have decided to focus any Collective Action on work we currently undertake that others, notably hospitals, pass onto us directly or indirectly; despite being required to deliver these services themselves.  We currently undertake this additional work to ensure that our patients are not inconvenienced by shortcomings elsewhere in the NHS system, but in doing so reduces the time available we have to see patients for the work we are contracted to do.

So what will be the impact on our patients due to our Collective Action?  Below are some examples that the Practice will begin to instigate over the coming weeks:

• Specific tests (ECG, bloods etc) that we are asked to undertake by a hospital specialists/doctor that should be undertaken in hospital whilst you are under their care, will be directed back to the hospital consultant to undertake.  This will mean the patient attending the hospital for these tests instead of the Practice.
• Requests from a hospital specialist/doctor in their discharge letter to us to onward refer the patient to another specialist in the same hospital will be directed back for them to do. This should actually improve the time taken for the patient to receive their onward referral.
• Hospitals are required to discharge patients with a sufficient supply of any prescribed medication – usually for 14 days.  Similarly, in a hospital outpatient clinic, any urgent medication should also be prescribed at the time.  This allows time for the patient’s discharge or clinic letter to be received by the Practice, to be reviewed by their GP and further/ongoing medication then prescribed as appropriate.  Where this has not occurred, patients will be redirected back to their specialist for their medication. This will mean patients having to wait for discharge medication, until a prescription is issued by the hospital dispensary/pharmacy.
• The hospital doctor is required to issue initial Fitness to Work (FIT) notes as appropriate as part of any discharge procedure rather than asking the GP to do, which may then require a further unnecessary GP appointment.  The patient will be redirected back to their hospital specialist/doctor for their FIT note, which may cause a delay to them receiving it.

For further information on the pressures on general practice, please see here: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis

Where our patients are affected by any Collective Action, then please accept our apologies.  Any such action is not taken lightly, and we will always put the care of our patients at the forefront of what we do. However, Primary Care are unable to keep undertaking extra work that we do not get resourced for (and for which others are already receiving  payment to do) whilst the overall GP workload continues to increase due to an aging and growing population, and our costs significantly increase.

Thank you for you understanding,

Rothschild House Group