The whole NHS system could be impacted by GP practices taking collective action next month and ICBs must prepare for it now, NHS England has said.
The commissioner wrote to ICBs and trusts yesterday warning about the impact of potential collective action by GPs, which is expected to start on 1 August, depending on the results of a ballot of partners.
The letter said that there is ‘uncertainty’ regarding the scale and impact of GP collective action, but that ICBs must take ‘a whole system view of potential impacts’ and ‘risks to patients’ when planning their response.
NHS England said that planning by ICBs should take into account the ‘secondary impacts and consequences’, including potential pressure on urgent and emergency care, elective and discharge pathways and impacts on mental health and community services.
It said: ‘It remains our hope that action will be averted. However, whilst discussions take place it is important we plan for all contingencies to keep patients safe – as we have in other periods of industrial action.
‘We are committed to having arrangements in place that manage the impacts in a reasonable worst-case scenario.
‘Regions and ICBs should draw on the expertise of their primary care teams in anticipating and managing changes to service levels in primary care but must take a whole system view of potential impacts and risks to patients when planning ahead.’
It added that there may be ‘short, medium, and longer-term changes’ to patient flows between and across primary care, 999, 111, and UTCs/MIUs and that ICBs should also understand any potential impacts on diagnostic and elective activity.
‘As in other disputes, maintaining services for patients with urgent needs, such as those with deteriorating conditions, meeting urgent diagnostic requirements, and ensuring timely triage to essential services will be key,’ NHS England said.
Given uncertainty regarding the scale of the collective action, ICBs were asked to stand-up proportionate incident management arrangements during August and to submit ‘a self-assessment of readiness’ to NHSE.
‘We are not requesting that ICBs contact each individual practice to ascertain their intent and appreciate in many cases it may not yet be fully clear which actions individual practices are likely to take, nor is it clear whether all practices will take part,’ the letter added.
But the letter added that ‘there should be open lines of communication with local GP practices and Local Medical Committees (LMCs) to ensure ICBs are made aware of any proposed service changes in a timely manner’.
And it said that although GPC England has ‘stated that they will not ask practices to breach their contract during collective action’, where practices ‘do change their service offer, commissioners may need to seek assurance from participating practices that national and local contractual requirements continue to be met’.
GPs were urged ‘take a stand’ and vote ‘yes’ to collective action, in a BMA ballot which will close on Monday next week.
In the ballot, GP partners are being asked if they are ‘prepared to undertake one or more examples of collective action’ as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice.
The examples include refusing to engage in advice and guidance and limiting patient contacts to 25 a day per GP.
The GPC said it is up to practices to choose which actions to take from the menu of actions and that it will be ‘inviting GP partners to work with their practice management team’ and with their LMC to determine the actions they will be willing to take’.
As part of the action, GP practices have been urged not to sign any new contracts with NHS England or local ICBs while the BMA’s GP committee ‘explores new opportunities’ with the Government.
A version of this story was first published on our sister title Pulse.
