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Bin practice boundaries altogether, says think-tank

GP practice boundaries should be disposed of completely and patients allowed to register with any CCG in the country, accessing all primary care providers within that region, according to a new report by the Institute of Economic Affairs think-tank.

The report published today, ‘A Patient Approach: Putting the consumer at the heart of UK healthcare’ discussion paper, calls for an NHS overhaul to allow CCGs to privatise, specialise and ‘compete’ for patients, through merging and demerging with other CCGs.

As a result, patients should be able to ‘choose freely among primary care providers, it says.

The Government has already introduced its ‘patient choice’ scheme, which allows practices to open up their boundaries and take on patients from out of areas.

As previously reported by Pulse, only 10,000 patients have registered with a GP away from their home since practice boundaries were abolished in October 2014, despite original claims from the Department of Health that up to 6% of patients were keen on moving to practices closer to their work.

But the IEA says that the Government should go further, and allow all patients to choose practices across the country, without practices opting in to the scheme.

The report says: ‘The whole concept of “catchment areas” should be abolished. Patients should be able to register directly with any CCG they see fit, and choose freely among primary care providers. Meanwhile, CCGs should be able to operate nationally, and to merge and de-merge with other CCGs, as well as provider organisations. CCGs would effectively become social health insurers, and the sector should be opened to private insurers as well.’

The think-tank also said it was ‘very much an open question’ whether GPs are the best people to lead CCGs. 

Instead, it recommends an ‘internal market’ in which ‘optimal size and scope’ of the CCGs would be discovered through a competitive process.

The report adds that this approach ‘would mean the end of political reorganisations, and the beginning of reorganisation by the market’.

Readers' comments (37)

  • Unless the duty for home visiting is removed, this will never happen. so end of story then.

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  • I have Eastern Europeans wanting to register from as far as Manchester.
    So let's not talk shop. This think tank needs some serious brain scans.

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  • no home visits = no boundaries. so far so good.
    how then do I control my list size ?
    Tesco provide a limited number of active tills. If there are not enough I can shop elsewhwere, is this what the thinking tank have in mind?

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  • ‘A Patient Approach: Putting the consumer at the heart of UK healthcare’

    The sooner we stop calling patients consumers the better. Healthcare does not work well with a business model.

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  • Patients should be able to do exactly what they want, when they want, get exactly what they want, as often as they want, whenever they want blah...blah....blah...
    has common sense completely left the building? Yet more reorganisation, more wasted money and utterly and completely impractical ideas! Do these people have any idea what day to day life in an average practice is like these days? Every day a plethora of stupid ideas comes along just when you think it can't get any more mad - it does!!

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  • What is the IEA and is "think tank" a misnomer? Why do they think we have to compete for patients? Much more of such (presumably) well-intended drivel that merely demonstrates a total lack of understanding of the function and ethos of good general practice and it'll be patients competing for the few remainng doctors.

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  • From what I can make out from the above it appears that the think tank want patients to register with a CCG, rather than a GP practice. So this implies that CCGs will hold the contract. This also implies that GPs will be employees of CCGs. Very interesting and extremely disturbing.

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  • GPs should; work voluntarily : wear pink shoes : eat grass - says thin tank. Idiots.

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  • Not only that, but CCGs are supposed to be commissioning bodies, not providers. This would make more sense if it was GP federations. Still very disturbing.

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  • "The report adds that this approach ‘would mean the end of political reorganisations'......"

    Definitely not in the real world, then

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