GPC England's LMC Update: 28 November 2025

emilymcdarby4
4 days ago
7 min read

Dear colleagues

No more point scoring – let’s prioritise practice wellbeing and patient safety

Yesterday, the Secretary of State for Health, Rt Hon Wes Streeting MP, wrote to all GPs in England. This is an unusual move, and it is in response to the GPC England officer team being firm in stating what we need for NHS general practice and with regards to the new requirements from October 1^st, including mitigations for safer management of online consultations that I know a lot of you are really struggling to cope with. We are here to help - if you feel you are getting unfairly pressured by your ICB, please contact your LMC or let us know via info.gpc@bma.org.uk.

In response to the Secretary of State’s letter, the GPC England chair, Dr Katie Bramall said:

“I want to thank the Health Secretary for recognising the hard work of GPs and practice staff. A record 40 million patients used NHS GP services in October. We warned this would happen - current pressures faced by practices are unsafe, unsustainable and need to be addressed. We’re worried that government doesn’t understand that safe, meaningful patient care can only be delivered when practices are supported and resourced. 34p per patient per day – less than the price of an apple – was already inadequate resourcing and the online access policy change further exacerbates this.”

When GPs entered into dispute with the Government on 1^st October 2025, it was underpinned by

the very real and present dangers of practices being overwhelmed by unlimited online queries. As the HSSIB (Health Services Safety Investigations Body) said yesterday in relation to electronic patient records, we must be wary that ‘systems which are poorly implemented, difficult to use, or do not meet the needs of staff and organisations can introduce avoidable patient safety risks, which can contribute to serious harm'. They previously published a report on online consultations in July 2025 confirming 'a proactive approach to identifying risks to patient safety must be undertaken'.

GPC England met yesterday on Thursday 27^th November where we discussed the current political situation and what our next steps should be. The safety of our patients and working in the best interests of you and your team remains our first concern. We don’t need any further point scoring. We need to work constructively to promote wellbeing in practices and safety for patients. We have repeatedly sought to work with government all year to make their aspirations a safe success but, in recent weeks, attempts have been thwarted by media briefings and nameless sources engaging in attacks on the integrity of the profession. For more information, please see our campaign page.

Our door remains open, and we continue to stand ready to put things right, as is our duty to the staff and patients we represent, to ensure care is safe for patients and practice staff alike, and to now move forward constructively.

We have had an approach today from the Government’s side which is welcomed, and we hope to keep colleagues informed with next steps.

GP contract consultation

This week, we learned that the government is going to consult on 2026/27 changes to the GP contract more widely. The fact is that relevant stakeholders are consulted in every annual contract cycle to capture a full breadth of views, but we are pleased that the government recognise this is a departure from their usual process.

GPC England may also decide to consult more widely, and we are confident there will be more consensus across various stakeholders than the government perhaps realises, and this provides an excellent opportunity for mutual collaboration.

If it comes to it, we can see how and why the government might want to avoid April 2026 changes being termed a contractual imposition, and there is a risk that they won’t even try to make it palatable, or potentially use the opportunity to deliver what will be a very difficult contract for the profession. We stand ready to deal with all eventualities.

However, the way things stand the government know they will have to engage with GPC England separately regarding the statement of financial entitlements - and they have confirmed that will be the case, so too have they confirmed their commitment to GMS renewal within this Parliament.

We now await with interest what their proposals are for 2026/27 - and we still await to hear back following the sharing of the safety concerns arising from the online consultation survey from over 1,300 practices – 1/5 of all practices in England. Thank you to those who completed this and we are using the data right now. You can read more on it here and below.

Online consultation survey results

Thank you to everyone who took the time to respond to our online consultation survey. More than 1,300 responses were received - one in five practices in England, representing nearly 14 million patients.

The survey showed significant concerns about the GP contract changes relating to online requirements introduced on 1 October 2025. 73% of responding practices said they had to change how they work because of the contract change, and many reported negative effects on both patients and staff. 42% of practices have had to reduce face-to-face appointments, reducing the time patients spend with their GP. 45% of these practices said they’ve had to redeploy staff to accommodate for the changes, and over half had seen a negative effect on patient care. Despite our warning of the risk of patient harm, 74% of practices had seen an increase in workload, 68% reported an increase in stress, and 54% said there was an increase in working hours.

Our current dispute with the Government includes this issue, after it failed to meaningfully engage with GPC England to deliver the necessary safeguards prior to 1 October 2025, as per our conditions to agreeing the terms of the 2025/26 contract.

We have repeatedly said that patient access must be clinically safe. To ensure that happens, practices must retain the ability to manage their consultation systems safely, including when demand exceeds safe capacity, rather than being forced to prioritise convenience over patient need in a woefully under-resourced environment. We urge colleagues to continue using our safe working guidance.

Watch a video of what GPs really think about the online consultation changes

Read more about the survey results and our dispute on the GP contract campaign webpage

BMA analysis of the budget

The Autumn Budget published this week included a range of measures which will likely impact GPs. From the perspective of employers, the National Living Wage, for workers aged 21 and over, is set to rise by 4%. It will be important that additional costs for GPs as employers are reimbursed and we will push for this.

Tax thresholds are being frozen, which will mean employees will pay a greater share of their income in tax as their salaries rise. Alongside the freeze in personal tax rates, the threshold at which employer National Insurance Contributions are paid will also be frozen, again placing upward pressure on GP employer costs.

Higher than expected inflation means that NHS budgets will grow at an even slower rate going forward. £300 million in additional capital investment was announced to support new technologies across the NHS. There was also a commitment to deliver 120 operational Neighbourhood Health Centres by 2030, with the government confirming these would be delivered via a Public Private Partnership funding model.

Pension changes should not affect the vast majority of us as the NHS pension is not a salary sacrifice scheme so the changes announced in the Budget on this aspect will not affect you.

Read the full BMA analysis of the Budget: Budgets and fiscal events - Budget - BMA

OpenSAFELY

Practices using SystmOne or EMIS Web are reminded to activate the NHS OpenSAFELY Data Analytics Service in their clinical systems following the data direction that was issued on 9 June 2025 by the Department of Health & Social Care. We understand NHS England have written to practices this week who are yet to activate to remind them. Instructions are available here. Activation is a legal requirement of the Health and Social Care Act. OpenSAFELY has the full support of the profession.

Neighbourhood Health Services and NHCs (Neighbourhood Health Centres)

The UK Government has announced plans to create 250 new NHCs (Neighbourhood Health Centres) in England, in line with the 10 Year Health Plan. 120 NHCs are intended to be operational by 2030 and are expected to bring a range of services (including general practice, physiotherapy, and others) together in a single ‘co-located’ space, with the stated goal of improving access to care and improving prevention. It remains unclear how these NHCs will interact with existing GP practices and other community services.

The Government also aims to use Public-Private Partnerships to fund the construction of the new NHCs, which has raised serious concerns about repeating the failings and long-term costs of prior Private Finance Initiative programmes. We must not see a repeat of the cripplingly expensive Private Finance Initiative from the 2000s which some parts of the NHS are still paying off with eye watering payments to private companies.

GP wellbeing resources

A range of wellbeing and support services are available to doctors, and we encourage anybody who is feeling under strain to seek support, such as the BMA’s counselling and peer support services, NHS practitioner health service and non-medical support services such as Samaritans. The organisation Doctors in Distress also provides mental health support for health workers in the UK. We have produced a poster with 10 top tips to help support the wellbeing of you and your colleagues.