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Analysis: GP choice scheme will not go away

The pilots of the abolition of GP practice boundaries have been less than impressive so far, writes Pulse reporter Sofia Lind - but don’t expect them to be put on the back burner just yet

The latest registered patient figures from the Government’s experiment of removing GP practice boundaries may have shown a 40-fold increase since Pulse last checked in in June, but from a very, very low base. A total of 514 patients is arguably not very impressive for a nine-month pilot across six PCTs.

Nonetheless the scheme warranted being mentioned as a ‘significant improvement’ for the NHS in the coalition Government’s mid-term review - indicating that this policy is not something that it is intending to drop in a hurry.

The coalition’s review said that practice boundaries were removed in six PCT areas, but the Government later admitted that a GP boycott meant no practices were operating the scheme in two areas.

Indeed the low GP uptake could be one of the reasons for the low uptake among patients. Out of 345 practices who could take part in the six PCT areas, 303 are not taking part. That is not by anyone’s imagination an impressive statistic.

The DH has not released its expectations for the trial - when approached by Pulse they refused to give a ‘running commentary’ on the scheme - but the GPC is clear when it says the number of patients opting in is low enough to question whether it is worth continuing.

It is certainly a lot less than the 120,000 patients one NHS-commissioned study predicted could register in the square mile of the City of London alone.

But despite the poor take-up to date, the move towards greater patient choice appears inexorable. East London GP Dr George Farrelly, an outspoken critic of the scheme in a series of Pulse opinion pieces, accuses the whole pilot of being merely a decoy, an excuse to abolish practice boundaries to make way for the corporate giants in healthcare provision.

He says: ‘Removing practice boundaries will essentially change the business model of primary care. That is what the Government wants.’

Whether you believe the conspiracy theory or not, participation in them has to improve if they are to prove their worth. The man with that job from April will be NHS Commissioning Board chief Sir David Nicholson.

Sofia Lind is a senior journalist at Pulse

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