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Your views on dual registration

In last week's Pulse newsletter, we asked for your views on the Government's decision to give PCTs the green light to set up systems allowing patients to register with more than once practice. Here's what you said.

In last week's Pulse newsletter, we asked for your views on the Government's decision to give PCTs the green light to set up systems allowing patients to register with more than once practice. Here's what you said.

Absolute disaster having dual registration - where do the records sit? Who claims the capitation payment? Who claims the QOF payment?

The list goes on besides which any patient can be seen at any practice as an 'immediately necessary 'or 'temporary resident'. Also, with the number of walk in centres and 'Darzi' health centres is there any need. Populist political nonsence which will further destablize primary care.

Judith Sissons
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As usual, a potentially good idea, but no in depth thought as to how it will work.

Is the Govt going to pay twice for patients to choose which GP they access for what and when?

Of course not, so how can it work.

If you're not registered with me in the suburbs, why should my PCT pick up all your urgent care for nothing and the other PCT/GP pockets the money to cover registration/QOF etc.

If the patient is allowed to see 2 GPs for anything he likes, how will the payments for LES/DES/QOF be worked out?

A total nonsense.

Let the patient register near work for sure, but any cover needed outside the confines of that practice will need to be covered by OOH/walk in facilities, not made the responsibility of suburban GPs.

Pete Budden
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Dual registration spells trouble (just as dual nationality causes confusion at airports) as a cunning patient will play one doctor against another to obtain supplies of medications which are rationed unless, of course, the other doctor can access the computer records.

Computer records as far as I am aware can only be accessed if both doctors are on the same computer system. No doctor would object if a patient sought advice from another doctor in an emergency situation but to actually register at place of work would mean he would use the work practice more than his normal practice as most people work weekdays and over the weekend periods both practices would usually be closed (at which time he would then access either a walk-in centre or a Darzi centre or the local AE).

This would in effect mean the patient can have 5 different opinions and advice which may not be the same. Already access to the Darzi centre by my patients has resulted in increase in antibiotic prescriptions and also wrongly advising that they need specialist opinion (which is hard to reverse when one doctor who perhaps has no competence in one field may say to the patient that specialist opinion is required, whereas his own doctor may be competent to treat that particular condition very effectively. But when doctors' opinions differ the patient invariably seeks a third opinion...alas more expense to the NHS).

Further more when a complaint arises with the new legal rules since all doctors in a practice may be sued, would this include the work place doctor?

Y Patel
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It seems strange to link dual registration with the flu pandemic especially when patients are advised to stay at home rather than visit the GP if they suspect they have pandemic flu.

I also think it will cause difficulties with continuity of care and may compromise patient safety e.g. trying to get medication from more than one GP practice.

Maggie Falshaw
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Dual registration: your views

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