(Alliance News) - Family doctors across England are to stage unprecedented industrial action amid a row over the new contract for GP services in England.
More than 8,500 GPs took part in a vote, the British Medical Association said, with 98.3% backing collective action.
Experts have warned that the move "could exacerbate access problems" for patients.
The BMA will encourage surgeries to choose from a list of 10 actions.
These include GPs limiting the number of patients they see each day to 25, refusing to share patient data unless it is in the best interest of the patient, and referring patients directly to specialists rather than following NHS processes.
Practices could also potentially ignore "rationing" restrictions by "prescribing whatever is in the patient's best interest".
Dr Katie Bramall-Stainer, chair of BMA's GP committee for England, said: "We had a huge response to this ballot, and the results are clear – GPs are at the end of their tether.
"This is an act of desperation. For too long, we've been unable to provide the care we want to.
"We are witnessing general practice being broken. The era of the family doctor has been wiped out by recent consecutive governments and our patients are suffering as a result."
Dr Bramall-Stainer added that action will be a "slow burn" rather than a "big bang".
"We understand that the new government has inherited a broken NHS, and we've had some positive conversations with the new Health Secretary about the situation in general practice," she said.
"This will not be a 'big bang'. It will be a slow burn. It's likely that impact may not be felt for some time.
"We hope this will give the new government time to consider our proposed solutions including fixing our contract once and for all.
"General practice should be the front door of the NHS, not the doormat. We don't want to have to take this next step but must if we're to stop our services from collapsing completely."
Doctors have previously said the action could last for "months".
Earlier this week, Dr Bramall-Stainer told the PA news agency that the action could bring the NHS to a "standstill very quickly" – though medics have said they do not want to make patients "piggy in the middle" and are directing the action at NHS England and the Department of Health and Social Care.
The BMA has said the new GP contract, which will see services given a 1.9% funding increase for 2024/25, means many surgeries will struggle to stay financially viable.
GPs launched a formal dispute over the issue in April after a referendum carried out by the union found 99% of 19,000 GPs rejected the contract.
Dr Bramall-Stainer told PA the action has been designed to be "easy, sustainable and effective" because it could last "week on week on week, month on month on month".
NHS England urged patients to come forward for care as normal during the period.
Practices will still be required to open between 8am to 6.30pm Monday to Friday during collective action.
Dr Amanda Doyle, NHS national director for primary care and community services, said: "GPs and their teams are the bedrock of the NHS, and we recognise they are working really hard and dealing with record demand.
"On behalf of patients, the NHS has a duty to plan for collective action, and we will continue to work with Government to find a resolution and end collective action.
"Our message to the public remains the same – they should continue to come forward for care during this collective action, as GP practices will remain open."
The NHS recommends patients use 111 for urgent medical help when their GP practice is unavailable and if it is a serious or life-threatening emergency to call 999.
Professor Kamila Hawthorne, chair of the Royal College of GPs said: "The result of the ballot shows the strength of feeling amongst GPs across England; the current GP contract is failing to provide GPs and their patients with the support that they need and more resources are urgently required to tackle this.
"No GP will want to restrict the services they provide for their patients – and it needs to be made clear that GPs and their teams will still be working.
"But there are many aspects of what GPs provide that go well beyond the contractual requirements they are under, and this additional workload and the goodwill of the GPs delivering it, have been taken for granted for too long."
Reacting to the BMA's announcement, Louise Ansari, chief executive of Healthwatch England, said: "Patients tell us they highly value their relationship with their GP, however, they persistently find it difficult to access timely appointments.
"Without proactive communications to patients, the work-to-rule action could exacerbate access problems or even deter people from seeking help altogether if they are unsure whether their surgery is still open to patients."
She also called for patient safety to be "paramount in any action GPs take", urging practices to keep patients informed.
"Ultimately, it's essential that the BMA and NHS England work with urgency to resolve the GP contract dispute," Ms Ansari said.
The BMA's announcement comes after ministers said they are planning to cut red tape to enable GP surgeries in England to hire more doctors.
The Additional Roles Reimbursement Scheme is a GBP1.4 billion fund designed to boost GP practice staff including physician associates and pharmacists, but not GPs or practice nurses.
The government has now announced that practices will be allowed to use the funding pot to recruit newly qualified GPs during 2024/25.
Officials said that the move is an "emergency measure" while the government "works with the profession to identify longer-term solutions to GP unemployment and general practice sustainability".
source: PA
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