Doctors have demanded an end to the ‘rationing of healthcare’ introduced by imposed contract variations which order GPs to make compulsory requests for advice from secondary care rather than having a right to refer.
A motion passed at this year’s BMA annual representative meeting called for all branches of practice to work together to urge a u-turn on the proposals and for the BMA to advocate for GPs’ right to refer their patients to specialists, to reject the concept of obligatory pre-referral advice and to recognise that the doctor who consulted with the patient is likely to know them best.
Oxford GP Helen Salisbury (pictured above) described the move as a ‘dystopian future’ where GPs would become increasingly frustrated, patients denied care and consultants spending ‘increasing amounts of time sifting through referrals trying to identify the ones they can reject rather than seeing patients’.
She said: ‘This motion is about the right to refer. It’s great to be able to ask for advice but when I want to refer my patient – a patient I may have met several times – I want to refer them so they can be seen as a whole patient not a form.’
Dr Salisbury added: ‘This affects all of us and will have an impact on our working lives and our patients.’
DATTA: Medical profession under attack
BMA consultants committee co-chair Shanu Datta said the committee had been working with NHS England on advice and guidance and that the new system was ‘unrealistic’. Both Dr Dattu and Dr Salisbury also agreed that the process must be carried out between doctors, rather than other professionals.
Dr Datta said: ‘In years gone past we would have called this out for the rationing of healthcare that it is, but in these times there is, in addition, an attack on our medical professionalism that permeates throughout health services.’
The contract variations, which came into effect in April, say trusts must respond to guidance requests within five days when routine, or two days when urgent and GPs have been asked to reduce referrals by 25 per cent. The changes were imposed on GPs by NHS England as part of the 2026/27 contract.