Collective action by GPs in England has been like “holding up a mirror” to primary care, with hopes that the health service will learn from the changes it has triggered, according to one of England’s top medics.
The British Medical Association (BMA) announced family doctors would stage collective action – meaning they can stop or reduce certain work as a way of collectively expressing concerns – in August.
The union then issued a list of actions for surgeries to choose from.
Dr Claire Fuller, primary care medical director for NHS England, told the PA news agency the move has been “really interesting”.
One option for surgeries to implement is to stop engaging with the e-Referral advice and guidance pathway.
This allows a clinician to seek advice from another unless it is “a timely and clinically helpful process”.
The BMA said the pathway “can lead to lengthy back and forth discussions with further requests for GP actions”.
Speaking of advice and guidance, Dr Fuller said: “Say you want to do a neurology referral, and the waiting time may still be quite long, you may do an advice and guidance to get some advice back from the consultant to help support that patient while they are waiting.
“You’re going to still carry on doing that, because that’s in the interest of your patient.
“So one of the things (collective action) has done, it’s accelerated the primary secondary care working.
“So getting GPs and consultant colleagues back in rooms to talk about the pathways that aren’t working. So bizarrely, that may be one of the positive legacies that comes out from it.
“It has been a bit like holding up a mirror for the bits that in your system where it pops up, and in some systems where it has had less impact than in others, which will probably reflect underlying positions.”
She added that it is “important” to look at the actions that were taken by surgeries during collective action, as well as the impact it had.
“Actually, not all the learning from it has been bad,” Dr Fuller said.
“I would want the primary secondary care conversations to be continuing. I would want GPs to be talking with consultant colleagues about which of the advice and guidance pathways work.
“There’s an element of, actually, ‘it was a point in time and it triggered a change’. I would want us to still continue to benefit from the changes that have happened.”