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Field: Defence of GP practice boundaries 'complete bollocks'

GP criticism of ending practice boundaries has been described as ‘complete bollocks', by Professor Steve Field.

The former chair of the RCGP and current chair of the Government's Future Forum on the NHS reforms said that the Government was seeking to dissolve boundaries now because family doctors have ‘failed large parts of the local population.'

Professor Field told the National Association of Primary Care conference: 'In many parts of the country we've failed large parts of the local population who can't even register with a bad GP,' adding: ‘The reason why Andrew [Lansley], Andy Burnham, Alan Johnson, all the way back, wanted to get rid of practice boundaries is that we haven't delivered but say that we are. We need to look at ourselves.

‘Yesterday I was speaking to a GP who said they wanted practice boundaries so they didn't have to take on everyone, because they wanted to make a choice because a particular patient might not fit in with how the practice is managing its care for its population. Complete bollocks.'

Professor Field's stance on practice boundaries, which will all but disappear in two or three city-wide pilots next year, is in contrast to his former view on the issue expressed when he was RCGP chair.

In 2009 received a standing ovation from RCGP conference delegates when he warned ministers outright abolition would be ‘crazy'.

But in a recent Pulse interview Professor Field said the practice boundaries agenda had ‘moved forward' in the past two years, and warned GPs must ‘raise their game' on access.

‘Most weeks I find examples where patients can't access GPs,' he said. ‘I've seen examples going round the country, in rural areas, where patients don't have a choice of practice because there is only one surgery in that area and the boundaries are drawn as such.'

From next April, GPs will be able to agree with their PCT an outer boundary where they will retain, where clinically appropriate, existing patients who have moved into the outer boundary area and want to stay with the practice.

In addition, practice boundaries will be scrapped within certain areas under large-scale pilot schemes established under the new GP contract.

Next year ‘commuters' in ‘two or three cities' will be able to choose a practice anywhere within the boundary of the pilot, while patients who move house will be able to remain with their existing practice even if they are no longer.

According to a joint NHS Employers and BMA statement, the one-year GP pilot will test two models by which patients in England can have more choice over which GP practice they use.

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