British general practitioners (GPs) are preparing for a second wave of coordinated industrial action that could impose significant financial strain on Integrated Care Boards (ICBs) across England, according to warnings from senior leaders of the British Medical Association (BMA). The planned walkouts, set to begin on 1 June 2024, follow months of escalating disputes over pay, workload, and NHS resources. With ICBs already facing budget pressures, the strike action threatens to deepen the crisis in primary care—a sector already stretched thin by staff shortages and rising patient demand.
The BMA, which represents more than 160,000 doctors in the UK, has framed the action as a last resort after failed negotiations with the government over a new pay deal for GPs. The proposed contract, which would see pay rises capped at 3.5%—well below inflation—has sparked widespread discontent among practitioners. According to the BMA, the financial impact of the strikes could run into the millions, with ICBs forced to cover additional costs for locum cover, emergency services, and potential patient redirection to already overburdened A&E departments.
Here’s not the first time GPs have taken industrial action. In March 2024, a one-day strike saw an estimated 10,000 GPs walk out, disrupting services across England and drawing sharp criticism from health secretary Stewart Stevenson. The government has since offered a £2.4 billion funding boost for primary care, but the BMA argues this falls short of addressing the root causes of GP dissatisfaction, including unsustainable workloads and a lack of investment in digital infrastructure.
Why the Strikes Could Be Costly for ICBs
ICBs, established under the Health and Care Act 2022, are responsible for planning and delivering healthcare services across 42 regions in England. Their budgets are already under intense scrutiny, with the NHS facing a £30 billion funding gap by 2026, according to the King’s Fund. The strikes could exacerbate these pressures in several ways:
- Locum costs: ICBs may need to hire expensive locum doctors to cover absences, with daily rates for GPs often exceeding £300 per session.
- Emergency service strain: Patients unable to secure GP appointments may turn to A&E, increasing pressure on hospitals already operating at capacity.
- Administrative burdens: The strikes could disrupt routine care, including chronic disease management and preventive services, leading to long-term health consequences.
- Reputation damage: Repeated service disruptions risk further eroding public trust in the NHS, complicating ICBs’ efforts to attract and retain staff.
The BMA has warned that the financial burden will disproportionately affect ICBs in deprived areas, where GP shortages are most acute. A recent BMA survey found that 42% of GPs are considering leaving the profession entirely, citing burnout and lack of support. The strikes, may serve as a catalyst for deeper systemic changes in primary care.
What Happens Next: Key Dates and Developments
The next phase of GP action is scheduled to begin on 1 June 2024, with further walkouts planned for 3–5 June unless a resolution is reached. The BMA has indicated that it will continue negotiations with the government but has not ruled out further action if the pay dispute remains unresolved. Meanwhile, ICBs are reportedly preparing contingency plans, including:
- Expanding the use of advanced nurse practitioners to fill gaps in GP services.
- Ramping up digital triage tools to manage non-urgent queries remotely.
- Seeking additional funding from central government to offset strike-related costs.
Health Secretary Stewart Stevenson has reiterated the government’s commitment to supporting primary care but has also warned against “disruptive” industrial action. In a statement, he said: “We are fully engaged in discussions with the BMA to find a sustainable solution that addresses the concerns of GPs while ensuring patients continue to receive the care they need.” The government has yet to confirm whether it will revisit the proposed 3.5% pay cap.
Who Is Affected and How?
The strikes will have a cascading effect across the NHS, but certain groups will feel the impact most acutely:
- Patients: Those requiring routine care, such as blood pressure checks or minor ailments, may face longer wait times or be redirected to overstretched pharmacies or walk-in centers.
- Chronic disease patients: Individuals managing long-term conditions like diabetes or hypertension could see delays in monitoring and medication reviews.
- NHS staff: Hospital doctors and nurses may experience increased workloads as A&E departments absorb more patients.
- ICB budgets: The financial strain could force difficult decisions on service prioritization, potentially leading to cuts in non-urgent care.
For patients concerned about accessing GP services during the strikes, the NHS advises:
- Using the NHS 111 service for non-urgent advice.
- Contacting a pharmacy for minor ailments where possible.
- Checking local GP practice websites for updated opening hours or alternative appointment systems.
Long-Term Implications for Primary Care
The GP strikes highlight deeper structural issues in England’s primary care system. Experts warn that without meaningful investment and reform, the sector risks a permanent decline in capacity, with potentially catastrophic consequences for public health. The Nuffield Trust has previously highlighted that GP practices are operating at 1.5 times their sustainable workload capacity, a situation that has been exacerbated by the COVID-19 pandemic.
Possible long-term solutions include:
- Increased funding: A sustained boost to GP pay and practice budgets to attract and retain staff.
- Workforce expansion: Training more GPs and expanding the roles of advanced practitioners.
- Digital transformation: Investing in telehealth and AI-driven diagnostics to reduce administrative burdens.
- Policy reform: Addressing the root causes of GP dissatisfaction, such as unrealistic patient targets and bureaucratic inefficiencies.
The BMA’s action has also reignited debates about the future of ICBs. Some critics argue that the boards, designed to integrate care across sectors, have struggled to deliver tangible improvements in primary care. Meanwhile, others believe the strikes could serve as a wake-up call for policymakers to prioritize GP-led care.
Key Takeaways
- The second phase of GP strikes begins 1 June 2024, with further action planned unless negotiations succeed.
- ICBs face millions in additional costs due to locum cover, emergency service strain, and administrative burdens.
- Patients may experience longer wait times for routine care, while chronic disease management could be disrupted.
- The strikes reflect broader systemic issues in primary care, including GP shortages, burnout, and underfunding.
- ICBs are preparing contingency plans, but the long-term financial and operational impact remains uncertain.
What You Can Do
If you’re a patient concerned about accessing GP services during the strikes, here’s what you can do:
- Check your GP practice’s website for updates on opening hours or alternative appointment systems.
- Use NHS 111 for non-urgent medical advice or to find the nearest walk-in center.
- Contact a pharmacy for minor ailments where possible.
- Monitor official updates from the NHS website or your local ICB for real-time information.
The next critical checkpoint will be the outcome of BMA-government negotiations by mid-June 2024. If no agreement is reached, further strike action could be announced. In the meantime, stakeholders—from ICBs to individual patients—will be closely watching how this dispute unfolds and its potential to reshape primary care in England.
We welcome your thoughts on this developing story. How do you think the GP strikes will impact healthcare access in your area? Share your experiences in the comments below.