This site is intended for health professionals only

Government forced to rethink patient ID checks to prevent registration fraud

By Christian Duffin

Exclusive: Government guidance requiring GPs to ask for documentary proof of new patients' identity and address has been placed under review amid claims it could deny healthcare to vulnerable patients.

It comes after an investigation by the RCGP's former health inequalities lead, Dr Angela Jones, revealed dozens of PCTs now have policies in place recommending practices demand identification from new registrants - with some GPs even routinely checking immigration status.

Official NHS guidance to GP practices on patient registration fraud was distributed across England eight months ago, but some sections may now be rewritten following opposition by Dr Jones, a GP in Oxfordshire. Click here to read the full guidance

She argues vulnerable people such as the homeless, travellers, asylum seekers and even students may be denied care because they are unable to produce the necessary documents.

The Friends, Families and Travellers charity has also raised concerns the guidance encourages GPs to turn away gypsies and travellers.

NHS Protect, formerly the NHS Counter Fraud Service, produced the guidance following a consultation with the Department of Health and the GPC to help tackle fraud, cut 'health tourism' and prevent patients registering at multiple practices to obtain prescription drugs.

Martin Wiles, head of policy and standards at NHS Protect, confirmed the guidance was now under review, but declined to give further details.

He said: 'There is no legislative criteria as to who is eligible to register for primary care but there is a requirement for the GP to make a discretionary decision about whether to accept a patient or not, and a practice can, if it wishes, ask for proof of identification and other documents.'

The BMA has taken legal advice on whether the guidance breaches any laws. GPC chair Dr Laurence Buckman said: 'The guidance is not discriminatory and it's perfectly legal.'

But Dr Jones said she was 'shocked' by the contents of the guidance, and called for it to be withdrawn completely.

'The fundamental principle that primary healthcare should be available to everyone and that this provision is not contingent on their lawful presence in the country is clearly not understood by the NHS as an organisation or by many of those working within it,' she said.

Dr Jones surveyed PCTs last summer using the Freedom of Information Act, and found that even before the NHS Protect guidance had been issued centrally, 31 of 142 respondents had policies recommending GPs demand proof of address and identification, while eight advised GPs to check immigration status.

Many PCTs, including NHS Birmingham East and North, NHS South West London and NHS Hertfordshire told Pulse last week they have circulated NHS Protect's guidance, but it is not clear how many individual GPs are implementing it.

A DH spokesperson said: 'GP practices have wide discretion in accepting applications to join their lists of NHS patients. It is common practise for a GP practice to accept a homeless person onto its list of NHS patients by registering them using the surgery address. Refugees and indeed asylum seekers would usually have documentary evidence which would confirm their status.'

Click here to read the full guidance

Dr Angela Jones