GPs Threaten 'Work-to-Rule' Over Pay Dispute, Potentially Limiting Patient Appointments
The British Medical Association is considering limiting daily appointments to 20 and redirecting some patient care to hospitals if pay demands are not met by the government.
General practitioners (GPs) in the UK are threatening to implement a "work-to-rule" strategy that could significantly limit patient appointments if the government does not meet their pay demands. The British Medical Association (BMA), the doctors' union, has outlined potential actions including refusing to see more than 20 patients per day and transferring certain duties back to busy hospitals.
These measures are part of a dispute over claims that GPs are being asked to manage increased workloads without adequate funding. The BMA is seeking more financial resources, a reduction in administrative tasks, and a government commitment to alleviate workload pressures. If negotiations with ministers and NHS officials do not yield "meaningful progress," industrial action, including the proposed appointment limits, could be initiated before December.
A document seen by the doctors' magazine Pulse states that these actions would be part of an "escalation strategy" if insufficient progress is made in discussions with the government. However, the BMA has indicated that they may call off the dispute if ministers agree to direct negotiations over the GP contract.
The current dispute follows contractual changes implemented earlier this year, which mandated that GPs offer same-day appointments for urgent health needs. At the time, the BMA warned that this could create an "unrealistic expectation" for patients, potentially overwhelming family doctors and straining resources. The union has previously stated that 20 patients is the maximum number a GP can safely see in a single day.
In response to the pressures on primary care, the Department of Health and Social Care (DHSC) has allocated £300 million to increase the working hours of existing GPs and recruit additional doctors. Former health secretary Wes Streeting described these measures as an effort to "fix the front door to the NHS."
Despite these government efforts, Dr. Katie Bramall, chairman of the BMA's GP Committee, cautioned that patient expectations for same-day appointments might not align with the reality of NHS capacity. She expressed concern that GPs are facing unrealistic demands for unlimited urgent care and that unnecessary barriers may arise for patients seeking specialist care, all while practices struggle to remain viable and avoid closures.