What is Collective Action?
On 1st August 2024, General Practice in England entered a period of GP collective action. More than 8,500 GPs in England took part in a ballot run by the British Medical Association; 98.3% voted in favour of taking part in collective action.
Collective action is not the same as industrial action but means that some GPs may stop or reduce certain work. Historically, practices have “over worked”: that is, they have worked above and beyond their contracts to keep up with patient demand. Collective action will see this “over work” reduce or stop.
Why Is Collective Action Happening?
General Practice funding is less than £108 per patient per year, this equates to at most 2-3 contacts per year per patient, compared to the cost of an outpatient appointment estimated to start at £130-£400, there is something about demand and reasonable expectation.
The £108 per patient, is to run practice premises and employ staff, this is not enough for GPs to employ enough staff to give patients the care they deserve. The financial situation is unsustainable, with many Practices having to shut, because they cannot afford to keep going.
Out Statement
Despite warning the Government that we’re being forced to do more with less, General Practice has not been given the funding it needs to handle growing pressures.
Here at North Leeds Medical Practice, the Appointment Hub system that we introduced in September 2023 brought our daily workload within our acceptable safe limits. However, we continue to feel workload pressures from:
- The number of patients who are waiting to book an appointment with us: we are unable to meet patient demand
- increasing administration often caused by pressures in other parts of the health and care system which takes our time and attention away from our patients and from doing the things that will make a difference to their wellbeing.
We have joined Collective Action as we believe that General Practice joining with one voice, may prompt the new Government to hear us.
What will change at North Leeds Medical Practice due to collective action
- We will start declining to carry out work that we are not contracted to do, even when in the past we have done it on the grounds that it may be more convenient for patients.
Hospital consultants frequently asked us to do work on their behalf. However we are not funded to do such work, neither are we required to do by the terms of our NHS contract.
Such work includes carrying out blood tests & other tests which the consultant has requested & the communication of results for tests which were ordered by consultants. The principle is: the doctor that orders the test should both administer the test (or their immediate team should) and follow-up the results of that test with the patient. - We are requested to complete unecessarily long forms in order to make a referral. We will naturally continue to provide all the necessary clinical information that is necessary.
- When the GP decides a referral is required then we will start ensuring that the referral is accepted. (Increasingly, and presumably to alleviate cost & workload pressures, hospitals are on occasion not accepting the GP referral but instead returning it to us with some advice & guidance for the patient to continue to treated by the GP/practice. We will no longer accept such advice & guidance as a response to our referral).
- We have introduced a daily Work Limit on our same day work.
GP Collective action – what is staying the same
GPs are not going on strike and we will remain open as usual.
There is no proposed action that will create a breach of our contracts. During collective action, we will continue to:
- Make appointments available
- Provide advice or care to patients by another means
- Give advice on alternative services
- Provide access to prescriptions, long-term condition management, vaccinations, make diagnoses and do referrals (including where clinically urgent)
Work Limit
To keep our workload safe & sustainable as we head into the busy winter period, and after much consideration, we have taken this step: to switch up the number of routine appointments we provide to vulnerable and complex patients for their routine and proactive care.
With our limited funding, we can achieve this only by switching down the workload of our “same day service”, by having a daily work limit.
NHS 111
If you think you need medical help right now, 111 online can tell you what to do next.
Click here to go to the NHS111 website
Urgent Treatment Centres in Leeds
They are open everyday 8 am to 11 pm (including bank holidays including Christmas Day).
– St George’s Urgent Treatment Centre, Middleton LS10 4UZ
– Wharfedale Urgent Treatment Centre, Otley LS21 2LY
Click here for more information
Walk In centre
The service is walk in only. You do not need to call prior to attending. There are no pre-bookable appointments
Please note they do not provide: Blood tests, Scans, Repeat Medication, Sick Notes, X-Rays
Shakespeare Walk-in Centre, Burmantofts Health Centre, Cromwell Mount, Leeds LS9 7TA
Click in this box to go to the WiC website
Work Limit Winter 2024/25
GP Work Limit, Winter 2024/25 – Frequently Asked Questions
To keep our workload safe & sustainable as we head into the busy winter period, and after much consideration, we have taken this step: to switch up the number of routine appointments we provide to vulnerable and complex patients for their routine and proactive care.
With our limited funding, we can achieve this only by switching down the workload of our “same day service”, by having a daily work limit.
What does a “Work Limit” mean?
Once we reach the Work Limit for that morning, or for that afternoon, some patients with acute issues may be directed to other services or asked to contact us another day if it is appropriate. [Before, all patients who contacted us with issues that we consider “acute”, would get a same day response.]
What will the Work Limit be?
The Work Limit will vary according to incoming demands (forms) on that day, and our capacity to deal with them.
What will stay the same?
Our Appointment Hub team will continue to read all incoming online forms and our patient Support Team will continue to answer all incoming phone calls. We will not “switch off” online forms. We will continue to book routine GP appointments ahead. This is so we can signpost patients appropriately, and so that we can continue to provide advice and care in situations which may be critical or for patients who need continuity of care.
If I am unwell, what do I do?
You should contact us as normal. If you are unwell and may be helped by an alternate service, then our care navigators will signpost you, mpst likley to NHS 111. You can also use the NHS 111 symptom finder at https://111.nhs.uk/ or call 111. You may also find the Health A-Z on the NHS website helpful: https://www.nhs.uk/conditions/
If you are unwell and feel you want care today: please contact us before 11am
I would like a routine GP appointment
Please contact us as usual. Via the online form if possible, or if not then call or visit us. We will continue to book routine GP appointments ahead, there is no change to this. In a routine appointment, the doctor has more time to hear your full story. We encourage patients to book routine GP appointments, rather than “on the day” – if you live with a long term health condition then routine appointments are the better way to provide the care you will benefit from.
What does vulnerable and complex mean?
This means people with:
– a worsening of a known condition-
– living with multiple long term conditions
– complex care needs
– receiving palliative care
– active suicidal ideation
– babies & children age up to 12 where appropriate.
We are prioritising care for these groups by introducing the Work Limit. The Work Limit will enable us to provide them more routine appointments.
If you are unwell and feel you must be seen today: please contact us before 11am
Background on Collective Action at North Leeds Medical Practice
General Practice is under resourced. More patients want appointments than we can supply. In a vote organised by the BMA British Medical Association earlier in the year, English GPs voted overwhelmingly in favour of taking collective action. The BMA is encouraging practices to choose from a list of ten actions: practices can choose to implement as few or as many as they think appropriate. The actions have one thing in common: they all involve General Practice declining to carry out work which it is not funded to do ie they are not part of General Practice’s NHS contract. For many years, GP has “picked up” such work. At North Leeds Medical Practice, in common with many other practices nationally, we have already implemented some changes.
Our work limit is part of collective action. The BMA advise that the safe number of appointments per doctor per day is around 25-28.
Patient information from NHS England
The NHS is asking the public to come forward as usual for care during collective action.
If you have an appointment with your GP practice, you should attend as usual, unless you are told otherwise.
Practices will still be open and see patients and you can book appointments through your GP practice.