“Are they here to destroy general medicine?” – GPs react to imposed contract changes


In a letter published on March 1, NHS England outlined changes to the GP 2022/23 contract, including requiring practices to make at least 25% of appointments available for online booking and to provide full services from 9 a.m. to 5 p.m. on Saturdays through the NCPs. .

The BMA said it was ‘bitterly disappointed’ with the changes, which it said were forced on the profession by NHS England – and warned the overhaul ‘ignores calls for further support and could lead to further long waiting times for patients”.

GPs responding to the letter also criticized the contract update, arguing it could force more doctors to seriously consider quitting, including partners. They add that the contract for 2022/23 could further ‘exacerbate the NHS crisis’ and widen the door to privatisation.

General contract

In its letter to practices detailing the changes, NHS England said it remained committed to the five-year contract agreement negotiated with the BMA in 2019. However, GPs said the changes for the next financial year would exacerbate current pressures and could prove nearly impossible to deliver.

Many said the failure of healthcare leaders to provide the support demanded by the profession could cause more GPs to leave partnership roles, cut their hours or leave the profession altogether. Responding to the news on Twitter, Dr Pippa McCabe said: ‘Those considering leaving will do so now. So much for retention.

“I fear it will end like dentistry, where a fee is paid. It goes against every NHS principle we have subscribed to, but the government wants to privatize so their friends can make money.

Dr Neena Jha, a salaried GP from Hertfordshire, also questioned the implications of the update deal for the GP workforce, saying it was “another way to push the general practitioners from”. Watford GP Dr Simon Hodes predicted it would have a significant detrimental effect on staff morale.

Results of a BMA indicative poll in November 2021 showed that of the 1,700 GP practices that responded, more than half (58%) were prepared to withdraw from NCPs during the next withdrawal period – and 39% were ready to disengage before that date.

But GPs have accused health officials of failing to listen to practice on the issue, insisting the contract actually continues to add to the work in this area. GP partner and Gateshead and South Tyneside LMC representative Dr Paul Evans said there was ‘nothing to support the practices’.

Others said patient care would suffer as a result of the changes. East London GP Dr Selvaseelan Selvarajah said: ‘NHS England unilaterally released the 2022/23 GP contract without discussing with GP representatives on the BMA GP committee to find real solutions for patients. This [is a] nearly empty offer that won’t help patients who struggle to access all parts of the #NHS, including #TeamGP. [It’s a] purely political gesture.

“This decision by NHS England is deeply unnecessary for patients who are not only struggling to access GPs, but are also coming to see us due to huge delays in outpatient appointments and surgeries. A sustainable NHS needs strong primary care [system]. Sad to see patients abandoned like this.

NHS England said in its letter: ‘We believe these updates will maintain stability and limit change for general practice, while bolstering investment in the workforce and leadership, helping our communities to recover and ensuring that patients continue to receive high-quality care in a timely manner. Thank you for your hard work supporting your populations.


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