GP leaders pledged “serious” discussions about action after NHS England imposed a controversial new contract on them last night.

The imposition came rapidly after GP leaders met Health Secretary Steve Barclay last week only to be told he would not intervene or provide support. It includes a tough new requirement that practices cannot tell patients seeking an appointment to “call back later”. Practices will be expected to offer an assessment of need or to “signpost” to another “appropriate” service when patients make their first call. It also requires practices to switch to cloud-based phone systems – although phone companies are expected to abandon all analogue phone systems within three years. Some £246 million of contract money will be set aside to reward practices for meeting access targets for patients. NHS England promised to reduce the number of Quality and Outcomes Framework indicators from 74 to 55 – but is adding two new cholesterol-related indicators.

The British Medical Association said the proposals “totally” ignored the need for extra support for practices.

Dr Kieran Sharrock, acting chair of its GP committee in England, said: “It’s extremely frustrating to see a second GP contract imposition forced on the profession, especially one that does absolutely nothing to improve what is fast becoming an irreparable situation for practices and their patients up and down the country. GPC England approached these contract negotiations in the spirit of collaboration, hopeful that common ground could be found, with the profession, finally, given the support it needs. Instead, the profession was roundly insulted by an inadequate first offer – which the Committee had no choice but to reject – and later subjected to a tick-box exercise meeting with the Secretary of State, who flatly refused to supply additional help to practices.

“This contract is the result of a failure to listen to what GPs actually need, and totally ignores the calls for any extra support to help practices meet the rising costs of keeping their doors open. Despite warnings from GPC England, it also introduces more bureaucracy and arbitrary targets that only set practices up to fail and take GPs away from direct patient care. Ministers have focused on eking out more without providing the resources to do this. Without investment to do more, practices have to free up resources from elsewhere. This hasn’t been properly considered, ramping up GP workload, and without the support needed, will lead to more GPs leaving the profession. Ultimately, it’s our patients who suffer most, and this means more of them will be left waiting longer for the care they desperately need.

“This is not the contract our profession or patients need or deserve. Staff will be incredibly worried about how their practices can now possibly survive. General practice can no longer be expected to take whatever is thrown at it, and the Committee’s recent rejection of the contract offer still stands. We will now look to enter serious discussions with our membership and the wider profession on what action we take next.”

Professor Aruna Garcea, chair of the NHS Confederation primary care network advisory group, said there was a “lot to welcome” in the contract.

Professor Garcea added: “However, to deliver real and long-lasting benefit to patients and staff in primary care, leaders are clear that it is important to not just fund the technology, but also the change. This will mean support to manage patient expectations during this transition, as well as taking a forensic look at the barriers to why some primary care networks and practices may have been slower than others to adopt these systems, making sure support can be tailored to local circumstances, and exploring the external challenges that can inhibit access and productivity. For example, over one in five premises in primary care are not fit for purpose currently and often these buildings are so cramped and rundown, and basic back-office support lacking, that any new recruits are held back from being able to work as efficiently as they would like.”

NHS director of primary care Dr Ursula Montgomery said: “GP teams have worked hard to deliver record numbers of appointments with half a million more delivered each week last year compared to pre-pandemic, and this new contract aims to build on this further with more access for patients. As well as providing same day care to more than two fifths of patients, GP teams will also step-up preventive action against heart attacks and strokes over the next year, with health professionals encouraged to prescribe statins alongside other preventative measures such as exercise to a much wider number of patients with heart disease, arterial disease and those who suffered a stroke or who have high levels of cholesterol.”