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LMC warns against GPs using practice address to register homeless patients

Local GP leaders have advised their practices not to register homeless patients using their surgery’s address, contrary to NHS England advice.

Worcestershire LMC told GPs that there are 'significant reasons’ not to register a homeless patient under the practice address, including taking on the liability of passing on important secondary care letters.

This comes after NHS England previously said GPs must register patients who have no evidence of a permanent address within the practice’s boundaries and can use their surgery’s address to do so, but have since added that GPs should sign over responsibility for maintaining contact to the patient if they are concerned.

Worcestershire LMC wrote in its newsletter that 'LMC advice is that a practice is not to use their surgery address', instead advising GPs to consider registering them at 'the address of the local Salvation Army', the CCG headquarters or 'a post office box'.

The newsletter said: ‘It is possible to register them [homeless patients] at your practice address but there are significant reasons why you should not do this...

'If a communication comes to your address on behalf of that patient it is your responsibility to locate the patient and pass on that information. Is your staff willing to take on such a role?'

However, NHS England told Pulse that if GPs have concerns regarding liability, they could have a signed agreement with the patient that sets out that it is the patient’s responsibility to maintain regular contact with the surgery in order to recieve any secondary care correspondence.

It added that under NHS England guidance, the practice can use its address where necessary to register homeless patients and if possible they should try to ensure that they have a way of contacting the patient if they need to.

When asked about whether practices who already have patients registered with the surgery address, without a signed agreement, could be held accountable if they cannot reach person, NHS England said it could not speculate as each case would be considered individually.

The BMA and CQC also offer advice on homeless patients, but neither have an official stance on what GPs should do.

A BMA spokesperson told Pulse: ‘Practices aren’t obliged to use their practice address to register homeless patients; they are expected to register all people who live in their area but don’t have to ask for evidence of an address...

'Our guidance on patient registration says homeless patients are entitled to register with a GP using a temporary address which could be a friend’s address or a day centre for example.'

Similarly, a CQC spokesperson added: 'Our role is to see that the relevant guidance is being followed rather than define it, but surgeries themselves may choose to use the practice address.'

In 2016, people without a fixed address - such as those who are homeless, those who live in hostels and those who ‘surf’ sofas - in London were issued ‘my right to access healthcare’ cards, with the aim of making it easier for them to register at local GP practices.

Readers' comments (7)

  • 'However, NHS England told Pulse that if GPs have concerns regarding liability, they could have a signed agreement with the patient that sets out that it is the patient’s responsibility to maintain regular contact with the surgery in order to receive any secondary care correspondence.'

    We all know that this will not hold water when GMC comes knocking...

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  • or the courts

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  • The CCG HQ seems a sensible solution tbh. I’m going to do this.

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  • Perhaps we need to be able to register people with NO address -without dishonestly filling in address fields. One for NHS Digital to sort.

    Then secondary care (or others) will realise that the patient is homeless and will have the same difficulty contacting them that Practices do.

    Maybe another reason for national ID cards -we just need to know who the person is and that they are entitled to be registered.

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  • Asking the patient to sign an agreement is just adding to the enormous bureaucracy we already have and it may also have an adverse impact on this vulnerable patient group. It is surely common sense to ask the patient, who is sleeping rough, which is their preferred c/o address Then to tell them to keep checking if there is mail (that's what I do). This is acting in the best interest of the patient. It is nonsense to suggest the practice is liable if the patient does not check their mail. They are far less likely to get their mail if they use the CCG headquarters! That is definitely not acting in the patient's interest and is called "Passing the buck"

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  • Just because NHS England passes the buck to us does not mean we have to hold onto it. Decades of being everyone's back stop should have taught us that. It is of course the patients responsibility to maintain a correct address. Not mine.

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  • A+E commonly uses
    "No fixed abode
    ZZ99 1AB"

    Or similar.

    I recently accepted this address, in a "synch PDS to spine" for one of my patients who is sofa surfing.

    Unfortunately this breaks electronic and also paper prescribing! Suddenly scripts will only issue as "record for notes" implying that you did a paper script. Needless to say we have gone back to a local address.

    Odd how the hospital gets away with ZZ99 ...

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