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One in three practices using full list policy

GPs with open lists turn patients away but get them back as allocations – Joe Lepper reports on our latest survey

More than one GP in three is stopping patients registering with their practice even though their list is open.

Figures from a Pulse survey reveal 37 per cent of GPs have turned away patients since April 1 but only 3 per cent of practices have formally closed their list.

Some 28 per cent of more than 200 practices said their list was 'open, but full'.

The figures reveal the importance to GPs of retaining the power to turn patients away without closing their list.

The GPC is adamant practices must use the full list argument to be able to refuse new patients and has advised GPs to use contract dispute resolution procedures if their primary care organisation stops them.

But despite signing off on the GPC guidance, the Government has since supported comments from former NHS Confederation negotiator Dr Tony Snell that GPs must formally close their list if they want to turn away patients.

Nearly half of 228 GPs surveyed said their workload would become 'intolerable' if they had to accept all comers and 38 per cent they would not be able to offer 48-hour access.

A quarter said they would have to close their list.

Dr James Bisset, a singlehanded GP in Comber, Northern Ireland, said he was telling prospective new patients his list was full. 'I have a list of 2,350. If I took any more it would have a serious effect on the quality and outcomes targets. At the moment I'm following GPC advice until this is squared out,' he said.

One in three GPs said they thought the GPC was right, but 57 per cent said they did not know who to believe.

The findings revealed many GPs are avoiding closing their lists because they fear losing out on enhanced services.

Nearly a fifth of GPs said their PCO was refusing to commission enhanced services from closed practices and 45 per cent said it would look less kindly on them.

Dr Derek Hopper, a GP in Grimsby with a full list, said GPs in the area had agreed not to take patients who were registered with another practice.

'What we aren't doing is turning people away because we don't like the look of them or because they live in a tower block,' he added.

Case study Had to declare list 'full' to protect quality

Dr George Paige reckons his 'full' practice will refuse around 800 requests from patients to join its list this year.

Dr Paige said the practice in Coventry had been forced to adopt the full list policy because its quality of care and access will drop if workload is increased further.

'At the moment we are going with the GPC's advice until we are told otherwise,' he said.

'When we were discussing the contract with the PCT, this scenario was mentioned and they were entirely happy to let it go. But that was in the last few days before the contract was signed so I don't know how they feel about it now.'

Dr Paige said the practice was still taking allocations and had accepted 18 so far this year.

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