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GPs' practice boundaries need to be abolished in order to bring in dual registration, the Department of Health's patient tsar has said.

Harry Cayton told Pulse practice boundaries were a 'traditional way of working' and acted as a barrier to allowing patients to register with more than one practice.

In an exclusive interview with Pulse, Mr Cayton said: 'Boundaries are one of the reasons why it's been difficult to turn [dual registration] into a practical proposition so far.'

Department of Health officials signalled last month that the community health White Paper would end GPs' right to set a boundary and bring in dual registration.

But Mr Cayton's comments are the first attempt by Government to link the two policies.

Mr Cayton also shed further light on how a system of dual registration would work. He said patients would remain registered with a 'home practice' which maintained overall responsibility, but should be able to visit another.

He said: 'Even with the question of dual registration you would still expect a single GP to be the primary provider.

'But I would like to see patients being able to register with more than one practice. The electronic patient record should make it possible soon

in a way that's safe and does

not undermine continuity of care.'

But GPs said IT systems were not mature enough to enable effective continuity of care and condemned the department's drive to end boundaries.

Dr Laurence Buckman, GPC deputy chair, said Mr Cayton's comments did not make sense.

He said: 'Boundaries are not there to protect GPs but to help patients.

'His comments don't have any bearing on reality ­ it's got nothing to do with tradition.'

Dr Chaand Nagpaul, a GP in Stanmore, Middlesex, said bouundaries gave patients the security of being able to receive a home visit and enabled GPs to look after a community.

It would make more sense to allow patients to register near their work and have out-of-hours cover still provided at home, Dr Nagpaul added.

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