A grassroots practice revolt against the government’s “name and shame” proposals to force an increase in face to face appointments is under way.

Practice leaders say the proposals are merely stoking abuse and violence against staff. One large local medical committee has advised practices to have nothing to do with the package – and another has suggested taking a “long pause” before participating. A practice boycott would mean practices not seeking help from the £250 million support fund – but they would also refuse to supply any more data about appointments.

A letter from Dr Michelle Drage, chief executive of the Londonwide Local Medical Committees, sets out how the level of abuse has been increasing in the capital.

Dr Drage tells practices: “Now might be a good time for us to take a very long pause. And assess whether it is truly in the best interests of ourselves, our staff and our patients to jump, yet again, when instructed. Other people’s boxes can always wait to be ticked – sometimes a very long time – when your priority is surely to care for the people in front of you.”

She goes on: “A recent straw-poll of London practices found over 9 in 10 (94%) are experiencing violence or abuse from patients, with 3 in 10 reporting over 20 incidents over the past three months. It speaks volumes that the only directly useful part of this package is the very small amount of money being offered to improve security. To shut a few stable doors after the horses have bolted. It does nothing to stop the abuse. Ultimately, this package is not about improving clinical care, but driving still more activity and risk to general practice and further demoralising an under-resourced and over-worked service. Suggesting unannounced CQC inspections is a threat, not a supportive measure.”

The chief executive of Surrey and Sussex Local Medical Committees, Dr Julius Parker, has also advised practices that they do not have to take part in the support package. Dr Parker says that changes are being imposed outside the GP contract.

In a letter, obtained by Pulse, Dr Parker writes: “In view of this recommendation by NHS England to extra-contractual performance management, SSLMCs advises all practices not to participate in any aspect of these proposals, until and only if, local negotiations can achieve a genuinely valuable and clinically evidenced alternative process. GPs do have a choice – none of these proposals are written into your contract and on none of these targets can your practices be performance managed. You can, and I am sure will wish to, ignore any attempts to do so.”