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Bin practice boundaries altogether, says think-tank



GP practice boundaries should be disposed of completely and patients allowed to register with any CCG in the country, accessing all primary care providers within that region, according to a new report by the Institute of Economic Affairs think-tank.

The report published today, ‘A Patient Approach: Putting the consumer at the heart of UK healthcare’ discussion paper, calls for an NHS overhaul to allow CCGs to privatise, specialise and ‘compete’ for patients, through merging and demerging with other CCGs.

As a result, patients should be able to ‘choose freely among primary care providers, it says.

The Government has already introduced its ‘patient choice’ scheme, which allows practices to open up their boundaries and take on patients from out of areas.

As previously reported by Pulse, only 10,000 patients have registered with a GP away from their home since practice boundaries were abolished in October 2014, despite original claims from the Department of Health that up to 6% of patients were keen on moving to practices closer to their work.

But the IEA says that the Government should go further, and allow all patients to choose practices across the country, without practices opting in to the scheme.

The report says: ‘The whole concept of “catchment areas” should be abolished. Patients should be able to register directly with any CCG they see fit, and choose freely among primary care providers. Meanwhile, CCGs should be able to operate nationally, and to merge and de-merge with other CCGs, as well as provider organisations. CCGs would effectively become social health insurers, and the sector should be opened to private insurers as well.’

The think-tank also said it was ‘very much an open question’ whether GPs are the best people to lead CCGs. 

Instead, it recommends an ‘internal market’ in which ‘optimal size and scope’ of the CCGs would be discovered through a competitive process.

The report adds that this approach ‘would mean the end of political reorganisations, and the beginning of reorganisation by the market’.