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GPC demands delay in practice boundary changes three weeks before rollout



Exclusive GP leaders are to urge NHS England to delay its flagship policy to give patients a greater choice of practice because of concerns that GPs and local area teams still do not know how the scheme will work in practice.

The GPC told Pulse that it plans to write to NHS England to call for the October implementation date to be pushed back because no national guidance has yet been issued for the scheme, which will allow GPs to take on patients from outside their boundaries without having to provide home visits.

This is despite NHS England saying in June that it was ‘urgently’ working on finalising the the details of the plans.

GPC deputy chair Dr Richard Vautrey said there is ‘a whole host of unanswered questions’ surrounding the policy, which could pose a risk to patients and therefore it would be ‘wise’ of NHS England to delay the rollout.

He said: ‘[October] is still the timeline but we have real concerns about that. We have had concerns about the removal of practice boundaries ever since it was suggested. This is an initiative that has been in gestation for a number of years now, and even with that long timeline we are now looking at three weeks before implementation and the health service is not ready for it.’

‘It shouldn’t be implemented if there is a risk that patients might register in one part of the country and not have available services should they become ill when they are at home because those services are not in place. And at the moment there is no sign of that because area teams have not yet been told, and have not yet been given the full details about what they should do.’

‘So I think it would be wise for NHS England to delay this until the guidance has been developed and area teams have commissioned home visiting or in-hours consultation services.’

Other outstanding unknowns include how much GPs will be paid for their out-of-area patients, given that they will not have to provide home visits, he said.

‘Patients on 1 October could walk into a practice and ask to be registered as an out-of-area patient and yet practices haven’t got any information at all about what it means and what the implications are. In many ways it is a bit like the NHS 111 implementation, we called repeatedly for it to be delayed, eventually it was and I think we were proved right.’

‘There is no urgency to do this and there is a risk that if they were to go ahead before everything was in place, and before the necessary services have been appropriately commissioned then there could be a risk to patients.’

The scheme has previously been criticised for being rolled out despite being insufficiently piloted, as the official pilot was dogged with delays and the final evaluation revealing that a third of surgeries failed to register a single out-of-area patient.

Pulse revealed last year that the pilot was struggling to get off the ground, with practices at two of the selected PCTs boycotting the project altogether and only 12 patients registering out of their area by June 2012, a number that was still only at 514 by the following January.

NHS England did not respond to Pulse’s request for comment.