Collective Action Letter

Dear colleagues,

Following the announcement from the BMA regarding Collective Action we have been discussing within Weymouth and Portland PCN what initial steps we might take.

This has also been informed by discussions with the Dorset GP Alliance and the LMC. We are aware of the importance to keep local providers and commissioners updated of any intended collective action and we hope his letter provides some much-needed clarity.

We have already given three months’ notice of our intentions in the letter of 19th September 2024. We have made a decision to defer the proposed start date in this PCN.  

Hence as of the 1st of January 2025, we intend to implement the following:

1. Request that local specialist haematology services take on the regular monitoring of patients with a new diagnosis of Monoclonal Gammopathy of Undetermined Significance (MGUS)
2. Request that the local specialist providers undertake any necessary blood test monitoring for at least two years following bariatric surgery.
3. Decline all new shared care requests for prescribing and monitoring of ADHD medications. 
4. Decline all new shared care requests for patients receiving hormone treatment for gender reassignment. 
5. Decline all requests for monitoring bloods for patients under the care of an eating disorder service.
6. Continue to work towards implementing the BMA safe working guidance of 25 patient contacts per clinician per day.

Alongside issues of capacity within Primary Care, the decision regarding the first five actions outlined above were also informed by concerns regarding clinical safety. These are areas which require specialist knowledge and training to appropriately manage and monitor. This specialist knowledge is unfortunately not uniformly available within the practices in our PCN and not supported by the specialist services. We therefore we do not feel it is safe to continue to provide these services as they currently exist.

We understand that these changes may have an impact on how patients receive some aspects of their care in the future. We would like to reassure you of our commitment to keeping our patients informed and updated of any changes so that any transition of care can be managed without any risk of harm.

Finally, we have significant concerns regarding the capacity for Primary Care to continue to provide adequate services for a number of other clinical areas including but not exclusive to phlebotomy, spirometry, specialist diabetic care and historic formal and informal shared care arrangements.

We understand that there are ongoing conversations between the DGPA, LMC and NHS Dorset regarding these and hope that a suitable solution can be agreed.

As a PCN we intend to review our position on the above and any other potential areas of collective action in January 2025.

Best Wishes,

Dr Sharlina Sallehuddin
Weymouth Bay Medical Practice 
Ann Klust
Wyke Regis & Lanehouse Medical Practice    

Dr John Usher 
Cross Road Surgery

Emma Winterburn 
Royal Manor Surgery

Dr Rupert Turberville-Smith
The Bridges Medical Practice 

Published: Nov 21, 2024