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Practices checking patients’ migration status takes ’30 minutes work per month’



A pilot that involved practices checking patients’ migration status found that such a move would add just 30 minutes of extra work per month for practices, the Department of Health has claimed. 

In a consultation launched today, the DH reiterated its intention for GP practices ‘to be part of administering’ extended migrant charging in primary care – including for services such as blood testing and lung function testing – subject to negotiations with stakeholders.

It cited results from a pilot designed to test the feasibility of practices routinely asking patients for a European Health Insurance Card (EHIC) or an S1 form, reported earlier in the year by Pulse,

The pilot found that such checks added a ‘minute or two’ every time a new patient was registered.

An impact assessment released alongside it found that the IT costs for rolling out such a scheme would be around £5m, but it is intended to claw back £41 from EEA patients’ home countries for every consultation with a GP or a nurse.

GP leaders have previously said GPs should not be have to check migrant status, but the DH consultation indicated that they will be asked to reconsider.

The DH pilot ran in nine GP practices from April to June this year and found that 13% of 2,116 newly registered patients were from outside the UK, but within the European Economic Area (EEA), although many ’were not aware that they were eligible for an EHIC, or did not know about them’.

Only 49 people (2.3% of the total number of registrants) presented an EHIC.

The DH consultation said: ’On average, collecting the additional data at the point of registration added an extra minute or two minutes per patient. Practices spent around a further 30 minutes each month processing the data and uploading data onto the portal.’

It added: ’The programme made clear in the 2013 consultation response that our intention was to extend charging in primary care and that GP practices would be expected to be part of administrating it.

’We have worked with a number of practices as part of the EHIC pilot to establish the most effective options for doing this. We are exploring making changes to the GMS1/GMS3 registration forms to embed these changes.’

The DH said chargeable primary medical care services would be ‘anything other than a GP or nurse consultation delivered in a GP practice or on behalf of a GP practice, e.g. phlebotomy, spirometry, minor surgery and physiotherapy’.

The consultation said that the ‘right solution’ had to be found to ’enable better data collection and data sharing on patients’ chargeable status between primary care and secondary care’.

It added: ’We will work with the BMA and the RCGP’s Joint GP IT Committee, the Health and Social Care Information Centre (HSCIC), and the NHS Business Services Authority (NHS BSA) among other stakeholders to identify the best way to implement these proposals.

’Further work will be needed to improve and integrate this into current GP systems. We will continue to work with stakeholders before publishing an implementation plan with more details, once the results of this consultation have been analysed.’

The consultation document also reiterated that GPs cannot automatically charge overseas visitors for consultations.

It said: ’Under current legislation GP practices cannot automatically treat someone as a private patient, or refuse NHS services, because the patient is an overseas visitor (contrary to the widely-held belief that this is possible).

’GPs can currently only charge overseas visitors if the person is first offered the choice of being an NHS patient but decides to pay to be treated as a private patient.’