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LMC leads boycott of practice boundaries scheme



Exclusive GPs all across a London borough are planning a boycott of the flagship Government policy to remove practice boundaries over fears it will disadvantage the most vulnerable patients.

Tower Hamlets LMC, which has been centrally promoting the boycott to practices, warned that the new rules allowing GPs to accept out-of-area patients from October would divert funding to the ‘articulate worried well’ at the expense of elderly and mentally ill patients.

From September, Tower Hamlets practices will be supplied with posters to place in their waiting rooms explaining to patients why they will boycott the scheme, a flagship Government policy aimed at improving access to ‘working people’.

It follows a Pulse survey earlier this year that found that less than a quarter of GPs were considering taking up the scheme.

The boycott is the latest indication about the popularity of the scheme, and Tower Hamlets leaders say that there is concern among GPs about how it will affect vulnerable patients.

LMC vice chair Dr Jackie Applebee said: ‘In Tower Hamlets the widely held belief amongst GPs is that opening practice boundaries will divert care from those who really need it to the more articulate worried well, as people exercise their right to register with a GP of their choice, those more vulnerable patients living nearby, such as the elderly, mentally ill and those who have complex multi-morbidity will be squeezed out.’

She added: ‘The buzzword of the day is “integrated care”. This means locally based, multi-disciplinary team working. We cannot deliver this if we are to care for patients who live miles away from our surgeries. With all of this in mind Tower Hamlets GPs have developed a letter for patients and a poster to put up in surgeries, explaining why we will not be abolishing our boundaries.’

Dr George Farrelly, a GP in Bow, who is organising the boycott, said: ‘Two months ago I warned my colleagues about this policy and most were aghast at this and thought this would not be right for Tower Hamlets. Coming September we are going to put up posters in our waiting rooms to say we are not doing this and why we are not doing it.’ 

‘There may be one or two practices that will not do it but the vast majority of us will openly refuse to do it, and we’ll explain to our patients why.’

Dr Naomi Beer, a partner at the Jubilee Street Practice in Stepney and leader of the ‘Save Our Surgeries’ campaign, said removing boundaries would be ‘irresponsible’.

She said: ‘Local practices wouldn’t have the capacity to take any more patients on. We are all full to bursting. In Tower Hamlets we have made it very clear that we feel it would be irresponsible to have open boundaries. I think there are other ways to address the issues that the Government has raised and I don’t think this is the right way.’

No other LMC leaders have as yet reported any joint approach to the opening of boundaries, although a Pulse survey of GPs conducted in March showed that 52% were not even considering the move, while 24% were considering it and a further 24% did not know. A further 73% of GPs said they did not agree with the policy, which was negotiated as part of the 2014/15 GP contract to come into effect from October.

It comes after the LMCs of Tower Hamlets, City and East London, Hackney and Newham staged a joint boycott of the Government’s pilot for removing practice boundaries last year, after east London was chosen represent one of four major inner-city trial areas across England.

Meanwhile, only 500 patients registered at an out-of-area practices in the regions where trials did go ahead.

In June, Pulse reported that NHS England still has not finalised the details for plans to allow GPs to take on patients from outside their boundaries without having to provide home visits, despite the scheme beginning in October.