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GPs told they must register people staying with friends, homeless and boat-dwellers



GP practices will have to register patients who have no evidence of a permanent address within the practice’s boundaries, including people living on a boat and those staying long term with friends but who aren’t receiving bills, NHS England’s new guidelines have established.

NHS England’s new patient registration directions confirm that GP practices have to treat tourists free of charge, as the BMA recently said.

The guidance says that GP practices can refuse a patient who lives outside of their practice boundary, but adds that the patient cannot be made to prove they live within it or prove that they are who they say they are.

It added that establishing an individual’s identity was ’not the role of general practice’. 

NHS England admits there could be ’practical reasons’ why a practice might need to be assured who a patient is or where they live and therefore it can ‘help the process’ if a patient can provide such documentation.

However, if a practice asks one patient, it has to ask all so as to not risk discrimination – and if they will not produce it, they still have to be registered.

NHS England said it was not a change in regulations but the guidance ’clarifies the the rights of patients and the responsibilities of providers’.

It said there was ’evidence of an increasing number of patients finding it difficult to register with some GP practices’ because they cannot prove who they are or where they live.

The guidance makes clear that GP practices can only turn down a patient for registration if ’the commissioner has agreed that they can close their list to new patients’, if they ’live outside the practice boundary’ or ’if they have other reasonable grounds’.

’In practice, this means that the GP practice’s discretion to refuse a patient is limited,’ it admits.

Listed as examples by NHS England as patient who ’do live in the practice area, but are legitimately unable to produce any of the listed documentation’ include:

  • People fleeing domestic violence staying with friends or family
  • People living on a boat, in unstable accommodation or street homeless
  • People staying long term with friends but who aren’t receiving bills
  • People working in exploitative situations whose employer has taken their documents
  • People who have submitted their documents to the Home Office as part of an application
  • People trafficked into the country who had their documents taken on arrival
  • Children born in the UK to parents without documentation.

However, the clarification comes as the Department of Health is preparing to launch a consultation on extending charging for NHS services from overseas patients in general, which could include them being charged for accessing GP services.

Pulse revealed earlier this year that the Government plans to ask GPs to request to see EHIC cards for all patients in areas with a high population of visitors from the EU.

These pilots would test the feasibility of practices routinely asking patients for documents to enable the NHS to recover the costs of primary care from their home countries in future, the DH said at the time.

CLICK HERE TO VIEW THE GUIDANCE