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GPC proposes fifth option on boundaries proposal

By Gareth Iacobucci

The GPC is set to submit a compromise proposal to the Department of Health’s practice boundaries consultation that would stop short of offering ‘unfettered’ choice of where to register, but would significantly revise current rules.

The Government’s preferred option would allow patients to register anywhere they choose, but create a dual-track registration, with only those living close to practices qualifying for GP visits.

But negotiators say both this option and three others for removing practice boundaries offered by the DH consultation document would be unworkable.

Instead, they are looking to propose a fifth option based on the GPC’s roadmap for reforming practice boundaries published in January, which would focus on changes to the ‘temporary resident’ arrangements.

The GPC says unregistered patients could be treated by a distant practice on an ‘ad hoc’ basis, with a ‘payment by results’ funding system ensuring practices are rewarded for each appointment.

GPC chair Dr Laurence Buckman said the Government’s proposals were not feasible, warning: ‘It can’t work the way they describe it.’

‘We are trying to see how we can offer a fifth option which will be acceptable to ministers,’ he said. ‘Obviously it includes fuzzy borders.’

Dr Buckman added: ‘Their option includes a concept of free registration. We don’t accept that, not because its protectionist, but because it’s against patients’ interest.

‘The idea of unfettered registration produces the kind of thing where a London GP is in charge of a Liverpool patient. A moment’s analysis of that will tell you that does not deliver adequate patient care.’

It comes after Pulse revealed last week that GPs’ opposition to the abolition of practice boundaries is set to dominate the agenda at year’s annual LMC conference.

A raft of LMCs including Cleveland, Nottinghamshire and Liverpool have tabled motions calling for the policy to be halted, amid fears it will severely damage continuity of care and prove unaffordable in the current financial climate.

Dr Laurence Buckman