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Only 10,000 patients registered out of area as part of Government’s flagship choice scheme



Exclusive Only 10,000 patients have registered with a GP away from their home since practice boundaries were abolished, despite original claims from the Department of Health that up to 6% of patients were keen on moving to practices closer to their work.

The revelation from NHS England comes as GPs at the LMCs Conference in London last week voted to abolish the scheme.

NHS England confirmed to Pulse that volunteering practices had registered around 10,000 patients from outside their traditional boundaries since January, when the changes to practice boundaries in the 2014/15 contract were implemented.

But this falls far short of the 6% of patients who the DH claimed were thought to be interested in moving to practices closer to their work when the scheme was first proposed by the Labour Government in March 2010.

The GPC said that the numbers for the scheme, which was enthusiastically backed by the Coalition Government, were small, but added that there were still safety concerns over the home treatment of patients who are registered out of area.

A spokesperson told Pulse that the 10,000 figure for the number of patients registered out of area – revealed by an anonymous NHS employee on twitter – was ‘about right’.

But it falls far short of the DH’s expectation. In a consultation on the practice boundaries scheme in March 2010, the Labour Government cited an Ipsos MORI poll from 2007, saying: ‘Six percent of people in this survey said they would want to register with a practice near their work and 18% said they wanted to register with a different practice in their local area.’

The Coalition Government also supported the scheme, aiming to widen patient choice by allowing people to register with the GP surgery they think is most suitable for them, regardless of where they live.

Yet NHS England’s ‘choice of GP’ pilot originally showed there was little demand from patients or practices for the scheme, with more than a third of the participating surgeries failing to register a single patient from outside their practice boundaries – a trend supported by these latest figures.

Commenting on the registration figure, GPC deputy chair Dr Richard Vautrey said: ‘10,000 patients compared to the millions of patients in the UK is still a relatively small number.’

However, he also warned that the safety of these patients was still ‘at risk’ in the absence of proper home-visiting cover all across all of England.

Dr Vautrey said: ‘The fundamental problem is that even under this arrangement at the moment, NHS England has not commissioned a full and comprehensive home-visiting service and so these 10,000 patients are at risk. If they become ill and can’t travel to their newly registered practice then there is no service in place in many parts of the country to provide a visit to them and that is unacceptable.

‘I think it puts urgency behind the need for NHS England to commission a proper comprehensive home-visiting service in every part of the country because now it is no longer tenable to actually delay on doing that.’

As previously reported by Pulse, the take-up of a new DES to provide home visits and urgent GP appointments to patients too ill to travel to their non-local practice has been patchy and NHS 111 has been advising some patients to go to A&E instead.

The GPC called in vain on NHS England to halt the the scheme in the absence of cover just two weeks before the 5 January rollout, after it had already been delayed once for that reason.

LMCs voted on Thursday to support a motion that lamented the scheme for fragmenting patient care, condemned NHS England for its failure to provide a comprehensive home-visiting service for patients and called for the scheme to be abolished.

The LMC motion in full:

AGENDA COMMITTEE to be proposed by HERTFORDSHIRE: That conference believes the out-of-area registration scheme has been a disaster and:

(i) believes the scheme fragments patient care

(ii) condemns NHS England’s failure to provide a comprehensive home-visiting service for patients registered as out-of-area patients

(iii) calls on GPC to negotiate the end of this scheme.