GP Appointment Cap in England – What Does It Mean For Patients?

The British Medical Association (BMA) has recently announced that GPs in England could start capping the number of patients they see daily as part of an immediate work-to-rule, following a dispute over funding.

What does ‘work-to-rule’ mean?

The BMA has told its members that they can limit appointments to 25 a day, compared to some GPs who see more than 40. The BMA has deemed this to be a safe level of operation.

It has been said that if every GP in England stuck to this patient limit, it would reuse the number of appointments by a third.

GP industrial action

In a ballot, 98% of over 8500 member GPs polled backed taking industrial action, with the BMA stating that a lack of funding is putting practices at risk.

The BMA is suggesting a range of actions, but it will be up to the GPs themselves to decide what they wish to do. The ten options that GPs have are:

1. Limit the daily patient contacts to a maximum of 25 people per clinician and divert patients to urgent care once that limit has been reached.
2. Stop engaging with e-Referral advice and guidance pathways unless in the patient’s best interests.
3. Serve notice on any voluntary services that plug local gaps.
4. End the rationing of referrals, investigations and admissions.
5. Switch off the software that allows third party entry into GP clinical records.
6. Withdraw permission for data sharing agreements that use data for secondary purposes beyond care.
7. Freeze the sign up of any new data sharing agreements.
8. Switch off NHS software embodied by the local integrated Care Board which tries to cut costs and / or rationing.
9. Refuse to share data from phone calls and keep online triage tools switched off during core practice opening hours.
10. Defer making any decision to accept local or national NHS England pilot programmes.

The last time GPs took collective action was in 1964, when family doctors handed in undated resignations to the Wilson Government.

How could the GP industrial action affect patients?

The BMA has said that action by GPs in England will be a “slow burn” rather than a big bang” and it has come in response to a new contract which will see services given a 1.9% funding increase for 2024/25. It is claimed that this means that many surgeries will struggle to stay financially viable.

However, there has been concern raised about the affect of potential industrial action, especially as there are already difficulties in patients being able to access face to face appointments with their GPs. In addition, there is fear that additional pressure will be placed on other NHS services. Campaigners and Health Experts have also warned the action could lead to “disaster” in cancer care and worsen A&E waiting times.

The BMA has insisted that they do not want patients to be “piggy in the middle” of the dispute, insisting that patients “won’t come to harm”. The Union has said it wanted the impact to be felt by policymakers and administrators.

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