GP practices General practitioner England

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Focus on industrial action and undated resignations

The purpose of this guidance is to provide GPs with a broad overview of the main areas to note should they be in a situation where they are considering, or being asked for their willingness to, submit undated resignations and/or take industrial action.

The broad categories of action that GPs could consider taking include:

  1. The mass submission of undated resignations
  2. Industrial action - involving the breaches of contracts by GP contractors
  3. Industrial action of a type that doesn’t breach contracts
  4. Action that is neither industrial action nor a breach of contract

It is important to note that there must be a trade dispute in place in order for any industrial action to be taken.

 

Executive summary

Please note that this summary must be read in conjunction with the full guidance in order to ensure you are fully and accurately informed of the complexities of this subject.

Clearly, any proposals for action must balance the intended impact with the effect on patient care, ensuring that patient safety remains paramount.

  • Mass submission of undated resignations

    • As part of co-ordinated action, GPs would submit to the BMA their letters of resignation from their practice contract/salaried contract
    • The conditions under which the BMA could submit these letters would be specified in advance
    • GP partners would need to take account of any contractual obligations they are subject to when submitting an undated resignation letter, for example their partnership agreement
    • No breach of contract involved and no need to inform the commissioner at the time of submitting the undated resignation
    • If not all partners in a practice wanted to submit undated resignation, partnership would need to be mindful of viability of practice with remaining partners
    • Partnership would be liable for costs of any practice redundancies and other associated costs, for example premises
    • Salaried GPs participating would be resigning from their contract with their practice
    • GPs resigning from their contracts would not be guaranteed an alternative contract in future
    • GPs resigning from their contract would need to consider alternative employment options in order to continue receiving an income.
  • Industrial action that could lead to a breach of contract

    • GP partners do not have the same (limited) immunities from the consequences of taking industrial action as employees do
    • If a practice refuses to do something which is a contractual obligation, they could be served with a breach notice or have their contract terminated irrespective as to whether it is done as part of a campaign of industrial action
    • Forms of industrial action which would breach contractual or other legal obligations could include:
      • The complete or partial withdrawal of essential services
      • The complete or partial withdrawal of other contracted services (without lawful termination of the contract on the required notice)
      • Non-compliance with various statutory and regulatory requirements such as:
        • Not undertaking appraisals (which would breach performer’s list obligations)
        • Not undertaking revalidation (which would breach GMC rules)
        • Failure to cooperate with the CQC (which would breach statutory requirements and which could result in a termination of practice registration and an inability of provide primary medical services)
    • Locum salaried GPs are not a party to the contract between the practice and the commissioner and so are not directly affected by it
    • A 'trade dispute' between a salaried/locum GP and their practice would need to be proven for salaried/locum GPs to take protected industrial action
  • Industrial action that would not breach the contract

    • The withdrawal of services that are over and above their contractual obligations would not constitute a breach of contract but could nonetheless be a form of industrial action
    • Such options may include:
      • Increased use of external referral as a means of discharging the obligation to provide essential services
      • Withdrawal of non-contractual services that GPs voluntarily provide
      • Withdrawal from additional services, such as the provision of contraceptive services
      • Withdrawal from enhanced services, such as the provision of minor surgery, extended hours
      • Withdrawal from the quality and outcomes framework
      • Temporary suspension of new patient registration
  • Full guidance

    The full guidance is available as a PDF download.

    Download the full guidance