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Majority of GPs to retain practice boundaries as GPC attacks Government ‘fetish’

More than half of GPs are set to reject the chance do away with their practice boundaries from October, a policy described by one GPC negotiator as a Government ‘fetish’.

A Pulse survey of 459 GPs revealed that 52% would not take on additional out-of-area patients, while 73% said that they did not support the Government’s decision to allow practices in England to get rid of their boundaries in the autumn.

GP leaders said that the results proved that the initiative was a Government ‘fetish’ that should be abandoned.

The DH successfully pushed for a clause to be inserted into the GP contract for practices to be able to register patients from outside their traditional practice boundaries.

The BMA agreed to the clause on the proviso that GPs could opt out of the clause if they could successfully argue that their catchment area was already large enough.

The initiative has formed a key part of the Government’s drive to extend choice for patients, and has already been trialled in six areas.

The GPC has already warned that the pilot showed there was ‘little appetite’ for removing boundaries, and GPC negotiator Peter Holden told Pulse that the survey findings did not surprise him, adding it was a ‘fetish that the Government needed to stop’.

He said: ‘This is just pandering to the commuterati…part of the purpose of a GP primary care system is to have a person that is responsible and someone who has an overview, if you allow people to register near their work and allow dual registration, information will get lost.’

Dr Saj Azfar, a GP in Rochdale, said that his practice could not take on larger boundaries.

He said: ‘We do not have the capacity to take on patients outside our boundaries. We also believe this will give make it easier for patients to evade child protection surveillance and provide opportunities for abuse of the system by those with interests in doing so.’

Dr Nicholas Britton a GP in Dorset said that as most GPs were already working at close to 100% capacity they did not have room to cope with more patients.

He said: ‘Home visits take up a lot of  time, especially if further from the practice and other  care, particularly as district nurses are commissioned by the CCGs to cover areas which often do not extend beyond  existing boundaries.’

A spokeswoman for NHS England said that the ‘Choice of GP Practice Scheme’ was being extended across the whole of England on a voluntary basis for practices, from October 2014.

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She said: ‘We are working with the GPC on the details of the implementation of the scheme and to help patients and practices take up this opportunity to improve access to GP services.’

‘Our approach will be a pragmatic one aimed at giving patients more flexibility and control about how they use GP services.’

Survey results in full

Do you support the Government’s decision to allow practices in England to get rid of their boundaries and take out-of-area patients from October?

Yes – 103 (22.49%)

No – 334 (72.93%)

Don’t know – 21 (4.59%)

Total – 458


Is your practice considering taking out-of-area patients after boundaries are scrapped in October?

Yes – 112 (24.4%)

No – 239 (52.07%)

Don’t know – 108 (23.53%)

Total – 459


About the survey: Pulse launched this survey of readers on 21 January 2013, collating responses using the SurveyMonkey tool. The 28 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey.

As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. These questions were answered by 459 GPs.


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