My practice alone does >200,000 consultations a year. 20,000 is utterly negligible

Role model to countless Tower Hamlets GPs and especially me. Lovely to see @phillipjbr being celebrated in this weeks @bmj_company. A great GP who embodies being part of a community.

GPs have won a major protection for patients in their negotiations with NHSE & Govt Guarantee of referral, no target for rejections, clear documentation of Advice and Guidance with Consultant name & GMC number Patient safety is always the priority Govt needs to listen to GPs

Good work w @NHSEngland & @DHSCgovuk re: referral processes This isn’t a ‘win’ it’s what it should always have been Next: the need for a safety framework when we face exceptional demand Secure that & we start on the new contract Alternative? GP Collective Action from May 1st

Disgraceful

NHS RATIONING

Dear @wesstreeting It’s past midnight. I’m not only on a non-working day, but I’m actually on annual leave. Partners work unseen, without fanfare or remuneration, for the best interests of our patients. I am pausing now whilst the caffeine-machine boots, to point out how little you recognise of what we do. You really need to protect partnerships, for the sake of the wider NHS. You will never find anything as cost effective as us. If I was an NHS employee, my leave would be spent in garden centres, pottery painting, at theme parks and sleeping. Instead it’s an opportunity to catch up on prescribing protocols, a new CDM & medication review process to harness best practice, and a variety of other things that enhance patient care and best use of resources. Annual leave is simply an escape from clinical commitment (partly, we are still contacted about it), to provide a space we can fill with other stuff. You really, really, REALLY need to support GP partners. There is no cohort who are better value than us. Give us a contract we can work with. You really really don’t want to lose us. Honest.

Tonight, @Keir_Starmer and @wesstreeting have decided to cut the number of offered specialist training jobs for doctors. Doctors need these jobs to train to become the specialist Consultants and GPs of the future that the NHS so desperately needs. Instead, this Government has decided to make it harder for you to see a specialist and is effectively holding doctors’ jobs hostage. We are already an under-doctored country compared to other OECD countries. In 2025, around 40,000 doctors applied for just 10,000 speciality training jobs. That means tens of thousands of qualified doctors ready to train, ready to work, and ready to treat patients are being turned away every year. The Government can train more specialist doctors when they want to. They are simply choosing not to. Remember this the next time you can’t get an appointment or your surgery is delayed.

Absolutely shocking behaviour from the health secretary! Threatening to withdraw training jobs for doctors if they don’t accept a real-terms pay cut… Knowing that the consequences of this will be our patients who’ll find it even harder to access to specialist care Disgraceful

This is absurd. If we need 4,000 training places we should have them. If we don’t, the Prime Minister shouldn’t be offering them as a bribe paid for by the taxpayer.

The suggested threat from @wesstreeting that additional speciality training posts for doctors could be withdrawn if doctors strike is extraordinary. Medical Consultants, Surgeons, GPs, anaesthetists, radiologists, and psychiatrists have to go through a speciality training post to finish their training. If you cut training posts, you are directly cutting the number of specialists the NHS will have in the future, that patients rely on. So what is being suggested here is essentially this: if doctors strike, the Government may reduce the number of future NHS specialists. That’s what the Health Secretary is suggesting. Doctors do not control how many training posts exist. The Government does. Workforce planning is a Government responsibility. The current bottlenecks, where tens of thousands of doctors apply for a limited number of training posts, were created by workforce planning decisions over many years. We already have a situation where tens of thousands of doctors apply for a limited number of training posts every year while the NHS says it has workforce shortages and patients face long waiting lists. The solution to that problem is obviously to train more specialists, not fewer. Using training posts as leverage in a dispute is not workforce planning. It is political pressure using the future NHS workforce as a bargaining chip. That should concern the public as much as it concerns doctors. Because fewer training posts today means fewer Consultants and GPs tomorrow. Fewer Consultants and GPs means longer waiting lists, overcrowded A&E departments, and worse access to care. Threatening to reduce training opportunities if doctors strike does not solve any of those problems. It just makes the workforce crisis worse. Training the future NHS workforce should never be used as a negotiating tool. bmj.com/content/392/bmj.s608

We have an important reminder about the @BMA_GP 2026-27 GP contract referendum: 🚨 By the end of today, 19 March: make sure you're a BMA member. 🗳️ By 25 March: find an email from bma@cesvotes.com in your inbox (possibly your junk/spam box) and vote. bma.org.uk/our-campaigns/gp-…

Thanks @wesstreeting @DHSCgovuk @NHSEngland -another solid non stop 6 hours today sat in front of a computer screen NOT seeing patients face to face due to the govt idea to allow unlimited access to GP time via a phone app. I did not become a GP to do this. I want to see patients

Yesterday you may well have seen the headlines announcing that from April onwards, GPs will be “made” to offer patients same day appointments for 'urgent' health issues. The implication, which I cannot imagine Wes Streeting is unaware of, is that he is on the side of patients, whereas recalcitrant & possibly even workshy GPs are the problem. A subtle undercurrent of GP-bashing, in other words, just as in previous governments. The headlines omit a crucial aspect of the new GP contract, which this letter in the Times brilliantly highlights. GPs will no longer be able to refer patients for specialist care as they do currently. New mandated "advice and refer" systems are being introduced for all specialist referrals from general practice, supposedly to 'streamline' care (as though GPs aren't highly trained physicians who know when a referral is needed). As anyone waiting desperately for an appointment with a neurologist, oncologist, rheumatologist or orthopaedic surgeon will already know to their cost, currently waiting times can be absolutely horrendous – and this looks horribly like yet another barrier to patients receiving the prompt care they need from a specialist. Already, for example, I am aware of patients with a new diagnosis of major, life-changing diseases such as multiple sclerosis, motor neurone disease or lupus having to wait many heartbreaking months to see a specialist for the first time. That is simply not right. It is a national scandal. If Wes Streeting’s aim is to massage the waiting list figures so that it ‘looks’ as though he’s improving care for NHS patients (while actually keeping patients away from doctors via a tortuous saga of ‘pathway navigators’ and other hoops that only create more delays) this would be an excellent way to do to.

Rachel is entirely correct @BMA_GP emergency meeting today We are almost one year since @wesstreeting wrote to me promising negotiation of a new GP contract which we agreed in good faith We need to meet now to avoid escalation

“Fix GP access!” There were over 30,000,000 appts last month GPs are not short of effort We are short of time Every unnecessary task pushed to GPs, means fewer appointments for patients #RebuildGP @BMA_GP

Perhaps this is something that ACPs, and AHPs could answer. I cannot see why a physio or nurse could not move into a pharmacists role using their advanced training if they can move into a medical role, particularly as the advanced training is designed for all AHPs

Lies… No more GP appointments Funding cuts due to NI and staff costs Partners falling Practices failing You are failing everyone

This figure is very telling. It is about 0.2% of the number of patients seen in GP in the same time period. A struggling GP service and a tiny increase in this fraction can collapse the whole system Never underestimate the volume and value in GP

This is the latest move by a Labour Govt - & shows their views of and approach to a Trade Union. It’s shocking & an attempt to discredit/sideline us. It won’t work. The universal reaction from GPs on dozens of groups is one of dismay & loss of faith in the govt. A serious misstep