We are urging GP partnerships and practices across England to take part in collective action to stay safe and sustainable in the face of the 2026/27 imposed GP contract. 99% of BMA GP members who participated in our recent referendum voted to reject the changes, which led to GPC England unanimously voting to prioritise negotiations with Government. Those negotiations, firstly around how GPs can refer patients on to specialist care, have been largely successful, yielding the required assurances.

But, secondly, how GPs and practice teams can practise safely when faced with patient need far exceeding available workforce capacity, has proved more of a challenge. GPC England has repeatedly flagged to the Government the day-to-day reality that for many practices they face exceptional pressures daily and that the imposed contract is impossible to deliver.

GPC England is recommending that the first action practices take, is around reviewing the GP patient data they are expected to share outside the practice, with the wider NHS and other organisations. GPs take their responsibility for their patient records very seriously, and this provides an opportunity to ensure all data sharing agreements have been rigorously scrutinised to be lawful, proportionate, and in the interests of the patient and the practice. This action will be beneficial to practices and should be welcomed by patients. It may create challenges for the wider Government agenda, especially with the increasing of work coming from hospitals to practices without commensurate resources under the ‘left shift’ agenda. 

We have therefore created a number of resources for practices and their LMCs, including a template letter to send to a practice’s local system,  as well as guidance on the single care record, GDPR in the context of lawful data sharing, and wider measures that GP practices can take to keep the profession safe, organised, and united in the face of commissioning gaps and challenges to clinical autonomy. 

Taking part in this and any subsequent future actions will both help your practice stay safe and put further pressure on the Government to appreciate the depth of concern across the profession with regards to impossible asks and the rationing of care creating such a lack of safety. Proposed actions will not breach your contract and are straightforward to do. Should further negotiations with Government fail to progress, and they do not heed GPs’ concerns about the contract, we will introduce further collections actions on an escalating, month-by-month basis  going forward.

Data sharing

From May 2026, the 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 below 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 (guidance for this with easy to follow screenshots for all GP systems will follow next week)

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