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Practices checking patients' migration status takes '30 minutes work per month'

A pilot that involved practices checking patients’ migration status found that such a move would add just 30 minutes of extra work per month for practices, the Department of Health has claimed. 

In a consultation launched today, the DH reiterated its intention for GP practices ‘to be part of administering’ extended migrant charging in primary care - including for services such as blood testing and lung function testing - subject to negotiations with stakeholders.

It cited results from a pilot designed to test the feasibility of practices routinely asking patients for a European Health Insurance Card (EHIC) or an S1 form, reported earlier in the year by Pulse,

The pilot found that such checks added a ‘minute or two’ every time a new patient was registered.

An impact assessment released alongside it found that the IT costs for rolling out such a scheme would be around £5m, but it is intended to claw back £41 from EEA patients’ home countries for every consultation with a GP or a nurse.

GP leaders have previously said GPs should not be have to check migrant status, but the DH consultation indicated that they will be asked to reconsider.

The DH pilot ran in nine GP practices from April to June this year and found that 13% of 2,116 newly registered patients were from outside the UK, but within the European Economic Area (EEA), although many ’were not aware that they were eligible for an EHIC, or did not know about them’.

Only 49 people (2.3% of the total number of registrants) presented an EHIC.

The DH consultation said: ’On average, collecting the additional data at the point of registration added an extra minute or two minutes per patient. Practices spent around a further 30 minutes each month processing the data and uploading data onto the portal.’

It added: ’The programme made clear in the 2013 consultation response that our intention was to extend charging in primary care and that GP practices would be expected to be part of administrating it.

’We have worked with a number of practices as part of the EHIC pilot to establish the most effective options for doing this. We are exploring making changes to the GMS1/GMS3 registration forms to embed these changes.’

The DH said chargeable primary medical care services would be ‘anything other than a GP or nurse consultation delivered in a GP practice or on behalf of a GP practice, e.g. phlebotomy, spirometry, minor surgery and physiotherapy’.

The consultation said that the ‘right solution’ had to be found to ’enable better data collection and data sharing on patients’ chargeable status between primary care and secondary care’.

It added: ’We will work with the BMA and the RCGP’s Joint GP IT Committee, the Health and Social Care Information Centre (HSCIC), and the NHS Business Services Authority (NHS BSA) among other stakeholders to identify the best way to implement these proposals.

’Further work will be needed to improve and integrate this into current GP systems. We will continue to work with stakeholders before publishing an implementation plan with more details, once the results of this consultation have been analysed.’

The consultation document also reiterated that GPs cannot automatically charge overseas visitors for consultations.

It said: ’Under current legislation GP practices cannot automatically treat someone as a private patient, or refuse NHS services, because the patient is an overseas visitor (contrary to the widely-held belief that this is possible).

’GPs can currently only charge overseas visitors if the person is first offered the choice of being an NHS patient but decides to pay to be treated as a private patient.’


Readers' comments (9)

  • Yeah man, "just 30 extra minutes a month". Only they forget the ocean is made up of drops.
    The answer is NO. They need to be taking tasks OFF not adding them ON.

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  • Actually 1-2 minutes per new registration PLUS 30 minutes a month PLUS however long it takes to decide when something is chargeable and handle that admin.

    What work can we drop to make this time?

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  • What can have exactly the same thing for free or you can choose to pay for it. Which one would you like? no brainer. So who is paying for it then if I'm not. Answer- the stupid taxpayer funded system where there is not enough for the people who contribute to the system in the first place.

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  • The issue is not around checking for the EHIC, but in demanding and validating patient's ID, - many British citizens do not have a passport or a driving license and will therefore be locked out of the NHS on those reasons alone.

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  • I don't understand this absurd need to "my rights to withhold information". In any other part of UK - be it mortgage application, joining a gym, entering an employment contract, you will need to provide a form of ID. I recently tried to join University as post grad distance learning student and I was told "I must show my ID IN PERSON" (as I have indefinite leave to remain visa) - no photocopy or scans would be accepted even if it came from secure NHS mail endorsed by partners/PM! But in health this suddenly becomes unacceptable.

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  • Apart from anything else, the sums given don't add up. 2116 new registrations in 3 months (it may even be 2, depending on whether the study ended at the beginning or the end of June) at 9 practices equates to an average of 78.4 registrations per practice per month. So, if you believe the figure of 1 to 2 minutes per registration, that means 78.4 to 156.7 minutes per month, the latter figure being over 500% of their estimate of 30 minutes per month.

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  • I've spent more than 2 hours on trying to find out why my patient who was seen three weeks ago non- pregnant with joint problems gave birth in the north of England 3 weeks later.
    Called the 'patient' and she confirmed is registered with us but living in a different county for 3 year. Next I know my non-pregnant patient - with same name, dob, nhs nr books an appointment for joint problems review. She's been checked by Police and found to be genuine too.
    Life is a bit more complicated that just doing a routine check. How far do you go in your scrutiny.
    How many of us have faced a situation where a person with a foreign passport has come in with a solicitor's letter saying his name has now been changed. Am I really able to check whether he is on Interpol's list for war crimes.
    How do you check a lady arrived from Timbuktoo pregnant and vanishes after childbirth from the country and you are unable to do childhood vacs. Will this child now entitled to British citizenship, crop up after 20 years seeking a passport?
    Or of the lady that calls from abroad saying she needs a letter for job centre confirming that she is living at a certain address with which she is registered in the Surgery although she or children haven't been seen for 2 years - she needs this to get child benefits.
    Life is too complicated and id checks are not for GPs. It is unwise to leave it to the hands of overworked GPs to police and the repercussions for the country can be significant over the decades.

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  • Adding to my post above 11:53- Migration checks should be completely erased from GP duties as the government is contradicting itself when they say GPs should not insist on id checks for registration and that every person has a right to register where he wants.

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  • And yet only last week NHS England issued guidance saying that all patients must be registered, even if they refuse to produce ID, otherwise vulnerable patients may be denied care.

    What about some joined up thinking, and clear, unambiguous guidance from the top?

    Personally I don't have an issue with checking any patient's ID, so long as it's the standard procedure across the NHS and the patient can't then complain to CQC/CCG/NHSE/GMC and the practice spend hours and hours apologising and defending itself.

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