In a referendum open from 23 June to 3 July, 98.7% of GP partner members said they were willing to take collective action on a turnout of 79.4%.
Next steps towards collective action
NIGPC in conjunction with LMC representatives have developed a list of collective action measures. Each practice and LMC area will be able to determine what works for their practice and local area. The collective actions measure have been assessed and evaluated by our legal team in BMA and we are confident that nothing breaches your contract, your professional obligations or any other regulations and statutory functions that you are obligated to observe.
A summary of the proposed collective actions is set out below. Before any collective action commences, the BMA will provide further detailed guidance in respect of each action, and such actions may be subject to change.
1. Limit daily patient consultations
Limit daily patient consultations per clinician to the UEMO recommended safe maximum of 25, as per BMA safe working guidance. If demand for urgent care exceeds safe levels, you may wish to consider directing patients to appropriate alternative settings such as urgent care centres, Phone First, GP out-of-hours, Accident and Emergency, and the Northern Ireland Ambulance service.
Why are we proposing this?
For the safety of patients – unrelenting demand means that GPs and their staff are seeing more patients than ever before within the existing resource and capacity. For the safety of GPs and their staff who are reporting unmanageable workforce pressures and the impact this is having on their well-being.
2. Serve notice on any voluntary activity
The focus of this action is to cease any activity that is voluntary, unfunded and non-contractual.
Examples of such activity includes non-emergency ambulance ordering (for example for first outpatient attendance) and the ordering of pre-procedural medications or medications used for hospital tests.
Action could also include serving notice on provision of complex wound and ulcer dressings, where this best undertaken by specialists.
There may be other activities that fall outside of GMS contractual obligations but have regularly been provided in general practice to prop up the wider health service. These will be considered further, and information will be provided in the detailed guidance.
Why are we proposing this?
This action highlights the work that many GPs currently undertake that helps the wider system operate effectively, but for which there is no additional resource. Such activity can make existing contractual obligations harder to deliver, potentially risking service quality, safety, and staff illness/burnout.
3. Cease completion of unfunded paperwork
GPs currently complete large volumes of paperwork which they are not contracted to provide and which they receive no additional funding for.
Examples of action that may be taken includes ceasing to complete paperwork associated with patient registration including dealing with patient eligibility for NHS Services. Practice staff are at times expected to follow up with patients to check documents that BSO require for registration. This is not the role or the responsibility of the practice.
Action could also include ceasing to complete letters to support for issues such as:
- patient applications for social housing
- educational provision in schools
- applications to the Home Office
- reports for benefits applications
Why are we proposing this?
This action highlights the work that many GPs currently undertake that helps the wider system operate effectively, but for which there is no additional resource provided. Such activity can make existing core contractual obligations harder to deliver, potentially risking service quality and staff illness/burnout.
4. Switch off Medicines Optimisation Software
Medicines optimisation software often produces nuisance pop-ups on the screen during patient consultations. These pop-up suggestions may not always be in the patient’s best interest as they are used for financial purposes.
Why are we proposing this?
Interactions with these processes uses up valuable clinician time that could otherwise be spent dealing directly with patients. The additional work associated with engaging in the software is not justified by the amount saved, which can in some cases be very little.
#GPsAreOnYourSide
To strengthen public support for our cause, we encourage GPs to display posters in their surgeries and use the graphics provided for your own social media platforms. These materials are designed to highlight the challenges faced by general practice and demonstrate the collective efforts being made to ensure quality healthcare for all. By engaging patients and the wider community, we aim to foster greater understanding and advocacy for the changes we urgently need.
Background and context
In May, GPs in Northern Ireland were asked in a ballot if they rejected or accepted the contract on offer from the Department of Health. 99.6% of those who voted indicated that they rejected the offer. The health minister subsequently said that negotiations were concluded and he moved to impose the contract.
When we began negotiations for the 2025-2026 contract, the negotiating team made it clear from the first meeting there were several ‘key asks’ in terms of what we believed was needed from this year’s contract agreement to stabilise and secure the future of general practice in Northern Ireland:
- An increase of £80million into core funding for general practice
- A fully funded indemnity solution for all GPs in Northern Ireland
- Funding to cover the increased costs of Employers National Insurance Contributions.
All of these are essential for GPs who are facing rising costs and increasing demand, putting additional pressure on an already stressed workforce. GPs have faced relentless criticism that patients are unable to see their GP or get an appointment, despite the Department’s own data showing this is not the case; 200,000 appointments are delivered every week, that is 10% of the population seeing their GP every week. Annually in Northern Ireland there are just over 750,000 attendances at A&E, so it is clear the huge volume of work GPs are undertaking for a fraction of the health budget.
An increase of £80 million into core funding represents about 1% of the overall health budget in Northern Ireland. It will help stabilise general practice but will also show that the Department of Health values the contribution of general practitioners. Currently general practice receives only 5.4% of the health budget despite the huge workload GPs undertake.
As you will be aware the roll out of indemnity did not happen as we envisaged in 2024/25, therefore for this year's negotiations we were clear that any indemnity solution needed to fully cover the costs all GPs face for indemnity.
Unfortunately, the current proposals from the Department do not in our opinion meet these key asks. We now want to get the views of all GPs and therefore we are asking you to tell us whether or not you view what is being offered as acceptable.
What was offered?
| Our asks | DOH offer |
|---|---|
| £80m invested into core GMS to stabilise general practice | £1 million additional investment in core GMS, tied to unagreed access changes |
| A fully funded indemnity solution for all GPs | Only £5 million for indemnity, paid on the basis of capitation, covering only partners/principals |
| Full funding to cover the cost of increased NIC charges | Minister promised £3.5 million for NIC costs - our ask is that the actual costs to practices are fully covered |
| Return of £5.6 million into the baseline core funding from 2023/24 | Agreed in principle, subject to further negotiation on exact distribution |
| Department of Health Ask | Our response |
|---|---|
| Changes to GP access - outlined through 17 proposals in access paper, issued 30 April 2025 | Committed to considering each of the proposals through an established working group in 2025/26 to ensure workability and safety |
The Department also issued a paper on access that outlines 17 actions that practices will be asked to implement. They believe that these actions will improve access for patients. On 4 June 2025 the Department and SPPG wrote to practices to inform them of the details of the new contract.