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Independents' Day

Only 10,000 patients registered out of area as part of Government's flagship choice scheme

Exclusive Only 10,000 patients have registered with a GP away from their home since practice boundaries were abolished, despite original claims from the Department of Health that up to 6% of patients were keen on moving to practices closer to their work.

The revelation from NHS England comes as GPs at the LMCs Conference in London last week voted to abolish the scheme.

NHS England confirmed to Pulse that volunteering practices had registered around 10,000 patients from outside their traditional boundaries since January, when the changes to practice boundaries in the 2014/15 contract were implemented.

But this falls far short of the 6% of patients who the DH claimed were thought to be interested in moving to practices closer to their work when the scheme was first proposed by the Labour Government in March 2010.

The GPC said that the numbers for the scheme, which was enthusiastically backed by the Coalition Government, were small, but added that there were still safety concerns over the home treatment of patients who are registered out of area.

A spokesperson told Pulse that the 10,000 figure for the number of patients registered out of area – revealed by an anonymous NHS employee on twitter – was ‘about right’.

But it falls far short of the DH’s expectation. In a consultation on the practice boundaries scheme in March 2010, the Labour Government cited an Ipsos MORI poll from 2007, saying: ‘Six percent of people in this survey said they would want to register with a practice near their work and 18% said they wanted to register with a different practice in their local area.’

The Coalition Government also supported the scheme, aiming to widen patient choice by allowing people to register with the GP surgery they think is most suitable for them, regardless of where they live.

Yet NHS England’s ‘choice of GP’ pilot originally showed there was little demand from patients or practices for the scheme, with more than a third of the participating surgeries failing to register a single patient from outside their practice boundaries - a trend supported by these latest figures.

Commenting on the registration figure, GPC deputy chair Dr Richard Vautrey said: ‘10,000 patients compared to the millions of patients in the UK is still a relatively small number.’

However, he also warned that the safety of these patients was still ‘at risk’ in the absence of proper home-visiting cover all across all of England.

Dr Vautrey said: ‘The fundamental problem is that even under this arrangement at the moment, NHS England has not commissioned a full and comprehensive home-visiting service and so these 10,000 patients are at risk. If they become ill and can’t travel to their newly registered practice then there is no service in place in many parts of the country to provide a visit to them and that is unacceptable.

‘I think it puts urgency behind the need for NHS England to commission a proper comprehensive home-visiting service in every part of the country because now it is no longer tenable to actually delay on doing that.’

As previously reported by Pulse, the take-up of a new DES to provide home visits and urgent GP appointments to patients too ill to travel to their non-local practice has been patchy and NHS 111 has been advising some patients to go to A&E instead.

The GPC called in vain on NHS England to halt the the scheme in the absence of cover just two weeks before the 5 January rollout, after it had already been delayed once for that reason.

LMCs voted on Thursday to support a motion that lamented the scheme for fragmenting patient care, condemned NHS England for its failure to provide a comprehensive home-visiting service for patients and called for the scheme to be abolished.

The LMC motion in full:

AGENDA COMMITTEE to be proposed by HERTFORDSHIRE: That conference believes the out-of-area registration scheme has been a disaster and:

(i) believes the scheme fragments patient care

(ii) condemns NHS England’s failure to provide a comprehensive home-visiting service for patients registered as out-of-area patients

(iii) calls on GPC to negotiate the end of this scheme.

Readers' comments (8)

  • Why is this a surprise - when the changes have not been advertised to patients?

    Run a TV campaign and a mass letter drop to all patients in the country and then assess the numbers who do or don't change.

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  • 10,000 !! Camoron and NHSE will declare this a roaring success.

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  • I hate to say I told you so, but every GP (Bar the hairy I want to work all day and night Manchester GP's) said there was no appetite for it. And we were yet again proven to be right. The say thing is the DOH will never listen to the grass roots, will only listen to their yes men. Will this be canned? no. Will statistics be manipulated to show what a wonderful success the scheme has been? of course.

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  • Because we have enough in our area already. The payments do not equate to an on call plumber.

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  • this is a flagship policy so will be pushed through until NHSE is accountable for it's mistakes (111 etc) it will continue to push put political non-evidenced ideas.

    we need to link NHSE failures to cost to NHS and public then someone will take notice and say 'hang on these quagos are costing us taxpayers money' they will then be some accountability.

    at the moment any desk based faceless policy maker can come up with an idea and if it get's a politicians imagination fired it will be pushed through simply as we get the blame and there is no link to accountability.

    we need to know who came up with this idea,m who backed them and how much has it cost the taxpayer.

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  • What we do not know is how many practices are participating. It is likely that many practices, especially popular ones, are already oversubscribed so are unable to take on additional, out of area patients.

    At best, this policy will provide an improvement for a limited number of mobile, relatively healthy patients. And if they get ill at home, then they may be in trouble. In London there is no in hours cover for local residents not registered with a local practice.

    It is really irresponsible of the Department of Health and NHS England to go ahead with the January launch without a robust and safe arrangement in place.

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  • If these are predominantly people wanting to register with practices closer to where they work, the chances of them needing a home visit out of hours are likely to be low, and quite frankly they should simply go to A&E: the increase in A&E activity will be so small as to be unnoticeable spread across the 200 or so A&Es in England. GP reps trying to make a mountain out of a molehill.

    As for only 10,000 people taking up the option; it's not exactly been published has it!

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  • It would seem that NHSE are relying that these people registering out of area are fit working people who will not require a visit - I wonder who undertook the risk assessment and decided not to put something in place. We struggle to meet needs of current case load without taking on the work of visting patients not registered here and as has been pointed out above they want you to do it for less than the price of a call out plumber ahhhhhhhhh

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