Mword Issue 112: Dr Michelle Drage’s message on the opening of the 2024/25 Contract Referendum and more

  • Mword

Also covering: NWL LMCs successfully push back on Same Day Access plans, why the Spring Budget offers little relief and guidance on staying safe.

7 March 2024

Dear Colleague,

Yesterday’s SpringBudget, unsurprisingly, brought us no joy. So today I have this list for you:

  1. Your 24/25 Contract Referendum – starts today
  2. NWL – Same Day Access update
  3. Spring Budget response
  4. Further Contract Referendum webinars
  5. London GPs WhatsApp group
  6. Get involved
  1. Your 24/25 Contract Referendum – starts today
    Last week we finally received details of NHS England’s contract for 2024/25. This contract has not been negotiated and GPC England has rejected it.

    With no recognition that we are shedding staff through burnout, ongoing unbearable workforce and funding pressures, this contract is a further raid on your ability to deliver your core essential services to patients safely. Whilst other parts of the health service receive funding uplifts of 6% to cover inflationary costs, GPs and general practice staff are expected to continue to do more with less whilst costs go up and funding goes down.

    Starting today, the BMA is holding a Referendum on this non-negotiated contract for 24/25. The referendum single question is:

    Do you accept the 2024/25 GMS Contract for general practice from Government and NHS England? Yes or No.

    The referendum is open to ALL GPs – Registrar GPs, Locum GPs, Employee GPs, or Employer GPs – but to ensure trade union law is complied with you need to be a BMA member. All eligible members of the BMA on 21 March can participate in the Referendum.

    Join the BMA now (before 21 March) to vote.
    The Referendum closes on Wednesday 27 March.

  2. NWL – Same Day Access update
    Following the intense and concentrated work of the Londonwide LMCs NWL team and your local LMC leaders we have now reached the position, confirmed in the messages sent to NWL practices yesterday by ourselves and by the NWL ICB, that “The Same Day Access programme will not form part of the single offer for enhanced services for 2024/25”. The key outcomes so far are set out in the ICB message, in addition to the removal of same day access from the single offer for enhanced services, there is agreement to prioritise continuity of care.

    This is only the end of the beginning. Londonwide LMCs and your local LMC team will be continuing these discussions – advocating for GPs and your teams shining a light on wider system pressures which are limiting our ability to provide the care we want for our patients, such as inappropriate workload transfer to general practice. We will continue to update you on our progress.

  3. Spring Budget response
    A lack of investment in general practice pushes even more demoralised staff towards the door, yet the Chancellor’s Spring Budget contained no hope for GPs in London or beyond. Only talk of further transformation, efficiencies and productivity. This political refusal to acknowledge the worsening crisis in our health system is a further attack on the provision of essential GP services to London’s patients, including some of the most deprived communities in the country. Read my statement here.
  4. Further webinars
    Following today’s London webinar, GPC England will be holding further sessions across the country explaining the background to, and timing of, the Referendum on the non-negotiated 2024/25 GP contract.

    Your GPC England reps in London have set up a London GPs WhatsApp group to communicate on next steps – follow this link from the phone where you have your WhatsApp account and join the group if you have not already done so.

    Further national webinars are also being planned by GPC England for:

    Further webinars are planned for other areas which will give the same presentation, so London GPs can join these if they missed today’s one.

    The rough timeline for action is set out here.
    You can read more about the current Contract changes here.

  5. London GPs WhatsApp group
    If you haven’t already done so, you may wish to join the London GPs group – just follow this link from the phone where you have your WhatsApp account and join the group, where your elected GPC England London representatives can share information.
  6. Get involved

    – staying safe
    A reminder that the BMA has issued clear guidance on your contractual obligations to be accessible to patients and, crucially, what you can do if you are challenged by your commissioner. I urge all GPs and practice managers to read this guidance which includes “protecting patients and clinical staff from the risks of decision fatigue, clinical errors, patient harm and clinician burnout by limiting clinical contacts to no more than 25 per day for each GP, and any excess demand beyond this being signposted to other settings such as 111, overflow hubs or urgent treatment centres”. This list is not exhaustive.

    Our GP Professional Support Network is also there for you if you are struggling with aspects of your working life.

    – highlight the pressure you are under
    The General Practice Alert State reporting system, which we are currently rolling out in London, highlights the pressures on general practice across the Capital in real time. By answering just six questions each week you can give us valuable, high quality, data to evidence the challenges you face and to change the narrative from individual practices being to blame for patients struggling to get appointments, to the more accurate reasoning that pressures on general practice are due to system-wide problems. If you haven’t already signed up, you can do so here.

    – help tell the story of London general practice
    We use data from our regular workforce surveys and elsewhere whenever we can, but human stories are far more impactful than data and we need people working in general practice to tell your story and show the people behind the jobs in general practice. These human stories help us to get media coverage, illustrate issues when meeting with local MPs and opinion formers, and create online campaigning resources. Anyone in the practice team can take part in these activities, as long as you can speak clearly about your work, what you do, and how that affects patient care. Our communications team can tell you more.

Please do share this MWord with your practice colleagues. As ever, I welcome your feedback at And do know that the team of experts and leaders here at Londonwide LMCs are here for you and by your side.

With best wishes




Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs