GP collective action - summary

Actions we've called so far

Starting from May 2026, GPC England will be announcing one new action per month details of which can be found below. So far we're calling for:

• Collective action on medical optimisation and prescribing choices
• Collective action on data sharing 

You can read about the background to the campaign here.

Why you should take part

Participating in these actions keeps your practice safe and puts pressure on the Government to address the unsustainable demands and unsafe rationing of care facing our profession. Proposed actions are straightforward and will not breach your contract. Should further negotiations with Government fail to progress, we will introduce further actions on an escalating, month-by-month basis.

June: medicines optimisation, and to making acute prescribing choices in the best interests of their patients

Medicines optimisation software is often embedded in clinical systems by an ICB for the purposes of system financial savings and/or rationing (rather than the clinical benefit of your patients). It provides prompts, alerts, or recommendations at the point of prescribing. Clinical systems already provide advice and guidance at the point of prescribing.

In practice, it often does things like:

• flag cheaper alternatives
• suggest formulary-preferred medicines
• highlight prescribing guidance
• prompt reviews or switches
• warn about duplicate or potentially unsuitable prescribing.

These tools are also commonly linked to ICB or local formulary policies, which are often written with cost and ICB prescribing budgets in mind.

Alongside action around this software, we are asking practices to make acute prescribing choices in the best interests of their patients, and to amend your acute prescriptions to safe and acceptable alternatives. 

Cost is one legitimate consideration amongst many, but it cannot be the sole determinant of clinical decision-making. It is therefore difficult to accept the increasingly intense focus placed upon marginal prescribing budget variances in general practice when these sums are often dwarfed by the multi-billion-pound annual deficits and overspends seen elsewhere in the NHS.
The GMC is clear that doctors should use NHS resources responsibly, but it is equally clear that our first duty remains to our patients. A GP who chooses between different formulations of a medication—whether tablet, capsule, liquid, branded or generic—may do so provided that choice is clinically appropriate, safe, evidence-based and acceptable to the patient.
You will know what is best for your patient within a consultation - but examples may include issuing a liquid suspension rather than a tablet formation (e.g. for those infants requiring a PPI) or a branded product over a generic formulation (e.g. Calpol for paracetamol).

 What practices need to do

1) Identify whether any medicines optimisation software use by the practice is contractually required, ie. under an LCS

2) Discuss whether the practice may wish to pull out of any LCS that requires it. It may be possible to continue with an LCS but not partake in the medicines optimisation aspect. Your LMC will be able to advise on this

3) Turn off any software that is not mandated.

The impact on practices

This will limit screen pop up distractions to the GP during patient consultations and could ensure prescribing decisions are in the patient’s best interest, as determined by the GP, rather than driven by financial imperatives of commissioners.  Prescribing should always be in the best interests of your patient in line with GMC guidance.

The impact on patients

Patients should see minimal impact, but will receive the prescription appropriate for the clinical presentation.

May: data sharing

From 1 May 2026, our first single collective action calls upon a practice to cease signing up to any new voluntary data sharing agreements (DSAs) that extract patient data for secondary uses , i.e. medical research conducted by charities, commercial organisations and universities or health service planning carried out by government agencies or local NHS organisations. Data used in this way is deemed non-essential for the direct patient care and therefore carries no inherent and immediate risk to patient safety if it is not shared.

We are also requesting that each practice sends a template letter to its local system to assess each existing DSA the practice is currently signed up to.

Under data protection laws, GP partnerships who run their own practices are the ‘data controller’ for the GP patient record, which means they are effectively the legal guardian. GP partnerships are contract holders and both legally liable for determining the purposes of processing their patients’ personal data and the means of processing the data.

Patient data can be accessed by the patient (the ‘data subject’), or other health and social care providers involved in a patient’s direct care. Patient data held within GP IT systems has the software supplier themselves acting as the ‘data processor’, a position that makes the system supplier accountable to act on the instructions of the data controller - the GP partnerships/contract holder(s).

The information collected about a patient can also be used for and shared with other organisations for purposes beyond their individual direct care. This is known as data processing for Secondary (Indirect) Care Purposes. This is the information we urge practices to stop sharing as it may not be lawful, nor in the interests of practices.

What practices need to do

1. Send the template letter to your local ICB, indicating you will stop agreeing to voluntary secondary uses data sharing agreements (DSAs) from May 2026

2. Refer any new DSA requests to BMA via [email protected]

3. Carry out an audit of all existing DSAs that your practice is currently signed up to (see PC IT Screen shots guidance)

4. Initiate a conversation with your patient participation group (PPG).

The impact on practices

Taking this action will necessitate some potentially useful ‘housekeeping’ for practices in having an opportunity to review all existing agreements and assessing which may be lawful, and which may not. Your LMC will also be able to support this process across your system – and ensure sound information governance. Your LMC will also be able to advise which DSAs are necessary to keep. We would urge practices to send the template letter to their local system, to place the onus on the ICB to provide the necessary information once across the system, rather than it being duplicated across practices.  It will also be good practice to communicate the partnership’s intentions transparently to the relevant organisations.

The impact on patients

Impact on patient care will be negligible – but the opportunity for greater transparency and trust will be welcomed by many patients. Maintaining the confidentiality of their record is important to many patients, and many are increasingly aware of data issues more widely – as evidenced by the high level of opt-outs seen during the 2021 attempt to rollout GP Data for Planning and Research. While more recently, the growing backlash against the involvement of Palantir in processing sensitive patient information in hospitals and national bodies, together with the headlines surrounding UK Biobank and its complete dataset being available for purchase online,has seen significant press coverage and grassroots resistance from patient and privacy groups.

The impact on the wider NHS

Withdrawing from voluntary ‘population health management' data sharing agreements for secondary purposes will impact the wider health system's ability to collect and analyse data for non-direct care activities. This includes the assessment and implementation of broader healthcare reforms, such as neighbourhood health initiatives and others set out within the Government’s 10 year plan. These rely on aggregated patient data to identify trends, allocate resources, and develop targeted interventions which may create additional workload for practices, without the necessary commensurate resource to undertake such work. The absence of such data may also hinder efforts for service delivery across the wider NHS.

Safe working

GPCE advocates safe working and empowers practices to identify unfunded work in their system  and to engage with their LMCs in local collective action to address local commissioning gaps. Our safe working guidance has been GPC England policy for a decade now, and continues to be so. We will continue to update our guidance in line with contractual changes as they develop. Contractual asks, such as patient access to online requests and queries, as well as requesting fit notes or medication queries, does not mean GPs must offer unlimited capacity that jeopardises safe patient care – yet this is what the contract is seeking. We will be modelling the impact to update and refine our safe working guidance as soon as we are able