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Boundary pilot practices could be swamped by 120,000 commuter patients, NHS research warns

Exclusive: The abolition of practice boundaries will see inner-city practices overwhelmed with commuters, with 120,000 patients set to register in the City of London alone, according to official research commissioned by NHS managers.

A report into the primary healthcare needs of workers in the City of London, drawn up for the City of London Corporation and NHS North East London and published this month, warns allowing patients to register near their workplace could stretch existing services to breaking point and create additional demand for dozens of GPs.

The warning comes after LMC leaders urged GPs in east London to boycott the Government's pilots of relaxed boundaries, over fears that an influx of patients would ‘inevitably' results in cuts to existing services.

A survey of 2,519 workers - published this month - found that 33% would prefer to register close to work, and 82% backed dual registration.

If all patients who wished to register near to work were allowed to do so, there would be an extra 120,000 registrations, requiring a further 14 practices to be opened to add to the sole practice currently in the Square Mile, the report warned.

It estimated 50 new GPs and 50 new practice nurses would need to be recruited, and additional adult counselling services and extended hours capacity would be required.

‘Initially resource use might be even higher, as newly registered patients tend to see their healthcare providers twice as frequently as patients who have been registered for a while,' it added.

The report said GPs working at the Neaman Practice in the City of London ‘recognised the potential benefits of City workers being able to register with a GP practice closer to work.' But they were concerned the practice did not have the resources to cope, the report said, and had queried whether the scheme represented value for money for the NHS.  

NHS City and Hackney is part of the current GP choice pilot scheme as well as NHS Tower Hamlets, where about 100,000 people work at Canary Wharf, Westminster, Nottingham, Salford and Manchester.

No practices have signed up from either City and Hackney or Tower Hamlets, even though the scheme was due to start in April, and few practices have signed up elsewhere.

Dr Sella Shanmugadasan, chair of the Tower Hamlets LMC, said: ‘They are not offering any additional resources during the pilot period to meet the extra demands. They are saying you must use the same level of resources to look after these people coming from somewhere else. We are already struggling to meet our needs with our existing resources.'

Last week's LMCs conference voted in favour of abolishing the practice boundary pilots. Dr Jacqueline Applebee, a GP in Tower Hamlets, said the pilot was ‘cynically calculated to appeal to voters' and ‘treated healthcare as a convenient commodity rather than a precious resource'.

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