Intended for healthcare professionals


Over half of general practices in England would quit primary care networks, indicative ballot shows

BMJ 2021; 375 doi: (Published 26 November 2021) Cite this as: BMJ 2021;375:n2924
  1. Gareth Iacobucci
  1. The BMJ

More than half of the general practices in England would be willing to withdraw from primary care networks in response to the government’s “rescue package” for the profession, results from the BMA’s indicative ballot earlier this month have suggested.

The BMA undertook the ballot to ask GPs whether they would consider undertaking four types of industrial action after its General Practitioners Committee formally rejected the government and NHS England’s contentious plan to improve access to general practice.12

Between 1 and 14 November the BMA surveyed the 5144 practices in England that have a GP partner who is a member of the BMA—representing around 79% of all practices in England. Each practice was given one vote.

Of the 1798 eligible responses received (a response rate of 35%):

  • 84% said they would be willing to not comply with requests for covid-19 vaccination exemption certificates

  • 80% said they would be prepared to participate in a coordinated and continuous change to their appointment book

  • 58% said they would be prepared to withdraw from the primary care networks directed enhanced service (DES) at the next opt-out period, and

  • 39% said they would be prepared to disengage from the DES outside the next opt-out period.

In addition, 87% of respondents said they would be prepared to refuse to comply with the contractual requirement for GPs to declare their income if it was over £150 000 (€180 000; $200 000). This policy has since been delayed until at least spring 2022.

Announcing the ballot results at the annual conference of England’s local medical committees, the new chair of the General Practitioners Committee, Farah Jameel, said, “To achieve this response rate in such a short space of time speaks volumes about the strength of feeling across the profession. The results showed that GPs and practice staff are frustrated, struggling, and desperate to see change. Make no mistake. This is a profession on its knees, and continuing to fight for its existence.”

Jameel added, “My election as the new leader of GPC England represents an opportunity for a reset. It is, naturally, a fresh start for the committee, but it also needs to be a fresh start for the profession.

“Today, I offer the government and the media the opportunity to participate in this fresh start—to step back from the rhetoric of division, to reflect on the dedication that general practice has shown in the most difficult of circumstances, and to demonstrate a willingness to work together to create solutions to this crisis.”

The BMA has not yet set out what action will follow the results of the ballot. Jameel said, “With the challenges of winter upon us, our next steps will be first to keep our patients safe in the ways that we as clinicians know how, and we at the BMA will continue to support the profession in the challenging months ahead.”


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