A document being circulated among GPs argues that the proposed industrial action currently being balloted on by the BMA is ‘the best choice to cause maximum disruption for government, but minimal harm to patients’.

The letter is signed by a number of prominent GP leaders, including BMA deputy chair Dr David Wrigley, chair of BMA London regional council Dr Gary Marlowe, GPC members Dr Jackie Applebee, Dr Louise Irvine, Dr Stephanie deGiorgio, Dr Zoe Norris, GP Survival chair Dr Matt Mayer, and LMC representative Dr Susie Bayley.

Practices are being asked by the BMA in the indicative ballot whether they are prepared temporarily to suspend new patient registrations or apply to their local commissioner for formal list closure as a form of industrial action.

Industrial action

The decision to ballot the profession was agreed by LMC representatives at their annual conference in Edinburgh in May in response to what they say is the failure of NHS England's GP Forward View to deliver the resources necessary to sustain services.

If practices vote 'yes' to action in the ballot, which runs until 10 August, the GPC will ask the BMA council to review the results and consider a formal ballot.

Advice published by GPC last week alongside voting instructions warned practices could face breach notices if any action is deemed a breach of contract.

The latest advice letter, which states it should be read alongside the earlier official GPC document, argues that ‘if carried out on the grounds of patient safety’, list closures are ‘allowed under the contract’.

Patient safety

It adds: ‘Any action by medical professionals is only done with a heavy heart. In advising practices to consider list closure, our representatives are clear that this is a way of causing maximum disruption to the government’s plans for the NHS, registering our disdain at their failure to adequately fund general practice, whilst causing no harm to our registered patients.’

The letter also encourages GPs to ask patients to support the action with petitions and letters to MPs. ‘Our patients are the strongest weapon we have in fighting for general practice. Tell them what you are doing and why,' it says. It adds that the risk to patients is greater if GPs do not take action to stop the collapse of the service. ‘If this list closure happens nationwide however it causes a significant increase in workload for NHS England, as well as public embarrassment to the government,' it says.

The document sets out a series of actions the government could take to resolve the crisis including increasing GPs' share of health spending to 15%, covering GP indemnity in the same way as hospital doctors, allowing patients to refer themselves for some secondary care services, and removing the hurdles to access GP Forward View money.