The Conference of England LMCs passed a resolution in November 2022, offering unequivocal support to all junior doctors including GP registrars, in their pursuit for pay restoration. This support was further demonstrated at a recent meeting of GPC England, where a resolution was passed with no votes against, offering support to all junior doctors, particularly GP registrars, in their pursuit for full pay restoration.
The ongoing junior doctor industrial action
Find out when the next round of action by junior doctors in England will take place.
GP registrars are junior doctors and are included in the strike. The action is a full walkout - this means that registrars taking part will not see patients on days of industrial action, nor will they be performing administrative work (e.g. reviewing bloods tests, checking hospital documents etc).
For those undertaking industrial action, our advice is to not attend their practice at all on those days.
Managing the impact of strike action on practice work
We strongly advise that practices cancel any clinics scheduled for GP registrars on those days in advance of the strike action. We would also advise not scheduling GP registrars to be duty doctors, on-call, triage, or equivalent on the scheduled days for strike action.
We know some patients are booked into clinics in advance and we are also aware that some important results ordered by GP registrars may come into the practice on strike days. We would suggest having an early conversation with your registrars to identify any patients who may need to have their appointments rescheduled or who may require urgent action on the days of industrial action.
GP registrar rotas
There should be no changes to or cancellations of the educational elements of GP registrars’ rotas during any industrial action. This is the position of GPC England, who are advising practices not to make any changes to the educational elements of GP registrars’ rotas, on days of planned action, due to industrial action.
Specifically, Self-Directed Learning (SDL) time, educational supervisor sessions, & Half Day Release (HDR) teaching should not be rescheduled into time where industrial action is to occur. Conversely, these activities should not be replaced with normal clinical time during periods of IA.
The running of GP practices should not be dependent on the attendance of GP registrars
GP registrars are an important part of the practice team, but they are supernumerary to the workforce of the practice. At no point should the effective running of the practice be dependent on the attendance of GP registrars, and they should not be used as a substitute for a locum in the practice.
Whilst registrars continue to be expected to provide valuable clinical services whilst in training, they are not generally considered a part of the workforce in terms of required staffing levels.
Potential impact on RCA
The RCA (Recorded Consultation Assessment) is the summative assessment of a GP registrar's clinical ability to consult with patients in a safe and effective manner. It uses pre-recorded audio or video consultations to evidence a registrar's competencies. A registrar can only undertake their RCA from their ST3 year of training onwards & they must pass the RCA in order to be given a CCT (Certificate of Completion of Training). More information about the RCA can be found on the RCGP's website.
The first wave of strike action is due to fall on the 13, 14 & 15 March. This is the week preceding the submission date for the RCA exam (21 March). Registrars due to CCT in the summer and who are yet to pass this exam will not be able to sit another of the RCA prior to their CCT date. The RCGP are also introducing a new exam (SCA - Simulated Consultation Assessment), the first diet of which is planned for November 2023. This adds further anxiety to an already high stakes exam. Anecdotally, GP registrars tell us that many of their recordings for the RCA are collected in the final weeks leading up to the RCA submission date. As a result, many GP registrars will be worried about losing recording time so close to the exam deadline.
We encourage all practices and supervisors to speak to their registrars about the impact of strike action on their RCA submission as soon as possible. We also encourage practices and supervisors to make pragmatic arrangements, so that registrars are able to have the appropriate clinical exposure needed to demonstrate competencies via their RCA recordings, whilst also still being able to undertake strike action, should they wish. These pragmatic arrangements may include: scheduling extra clinics, moving non-RCA related educational sessions after 21 March, or intensively identifying patients to add to a registrar's clinic list in order to achieve the correct mix of pathology required for the RCA.
HDR (Half day release teaching)
We would encourage any GP educators, who are involved in the the delivery of HDR, to presume that HDR will occur as normal and plan accordingly. If HDR is scheduled to occur on days of industrial action you may wish to use this opportunity to provide teaching on relevant subjects such as: medico-political advocacy, effecting systemic change in healthcare environments, or supporting GP registrar well-being.
Advice on picket lines outside GP practices
Junior doctors, including GP registrars, undertaking industrial action are only able to join picket lines at their usual place of work. For GP registrars working in a practice setting, this would mean picketing outside their practice.
However, this fight is not against GP practices and therefore, we are encouraging GP registrars who are taking part in IA to join protests at their nearby hospitals as we expect the majority of junior doctors on the selected days to demonstrate there.
Further information on these demonstrations will be made available by local BMA staff (IROs), and we would encourage any GP registrars to contact them should they wish to join a demonstration. If you are unsure of how to reach your IRO, contact us.
Requests for information from a GP registrar's lead employer
Lead employers will not know which registrars have and have not taken industrial action. They will have to ask either the registrar or the practice for this information but there is no legal requirement for an employee to report their participation in industrial action .
Supporting GP registrars during strike action
Given the importance of the success of this action for the whole profession, we would encourage all practices to visibly demonstrate their support for GP registrars in undertaking this action.
This support could be demonstrated by the following actions:
- Explaining to patients why GP registrars are undertaking industrial action to achieve pay restoration
- Displaying posters in waiting rooms
- Sharing explanatory material with non-clinical staff within practices who may be asked by the public about IA
- Sharing information / graphics for practice websites and social media pages
- Distributing/leaving leaflets in waiting rooms
- Badges/stickers for practice staff who want to support
- Changing patient-facing messaging for the impacted days to highlight the action and highlight the impact on services. See below.
"Thanks for calling <insert name> practice. Our GP registrars, along with other junior doctors, are taking industrial action over a real terms pay cut of more than 26% since 2008. As our GP registrars are not in the practice today, we have fewer appointments available than normal. If you think your problem can be dealt with on a non-strike day, we’d be grateful if you could call back. This first round of strike action will finish at 7am on Thursday 16 March. Thank you for your support and we’re sorry for any inconvenience"
Advice for local medical committees
Whilst they are not trade unions and so need to be cautious over the action they take, local medical committees have a vital role to play in encouraging practices to demonstrate their support for their registrars in participating in this action.
We would encourage LMCs to distribute the resources in this guidance to the practices in their regions, along with encouraging them to proactively demonstrate their solidarity with, and support for, GP registrars. They should also direct registrars to our GP registrars industrial action guidance. We would also encourage LMCs to invite registrars to their LMC meetings and allocate time for registrar/industrial action updates on their meeting agendas.
This is an action endorsed by the BMA and which has the full support of GPC England and the LMC England conference.
Advice for GP trainers and training programme directors
To improve the chances of success of this action, GP registrars would benefit from the clear and visible support of GP trainers and training programme directors (TPDs) to ensure that GP registrars feel empowered to take part. This action is not only for GP registrars, but for the future of General Practice and the medical profession as a whole.
As GP trainers and TPDs are not the employers of GP registrars, you have the ability to express your support for this action and we would encourage you to do so.
If you as a GP trainer or TPD have specific concerns with the action, we ask that you consider the points covered in our guidance around the ethics of taking industrial action. We hope that the success of this action should be to the benefit of the whole medical profession.
You can help support your registrars by sharing the information which the BMA has put together for GP registrars.
How to help support GP registrars financially
There are two options are available if you want to financially support junior doctors and GP registrars in undertaking this action. These are detailed below:
1. Make a contribution to the BMA’s strike fund
The BMA has set up a strike fund, through which donations can be made to support doctors who have taken part in industrial action but need financial support as a result of the deductions to their pay made due to participation in the action.
The BMA is asking donors to commit the equivalent of an hour’s salary to the strike fund each month for a six-month period.
The strike fund is available for all junior doctors in England to apply to. The strike fund will be available to subsidise members in serious financial difficulty who otherwise couldn’t afford to take part in any future rounds of strike action.
2. Make a gift payment to your practice’s GP registrars
There is no obligation for any practice or individual to support GP registrars financially during this strike action. GP registrars should make the decision to undertake strike action under the presumption that they will be receiving a deduction to their wages from their lead employer. See our full guidance on gift payments to GP registrars during industrial action.