GPs to register homeless, boat-dwellers and people staying with friends

NHS England’s new patients registration directions also confirm that GP practices must treat tourists free of charge.

The document notifies that GP practices can refuse patients living outside the practice’s boundary, but adds that patients cannot be forced to prove they live within boundaries or their identity, claiming this was ‘not the role of the general practice’.

However, NHS England did admit there were ‘practical reasons’ that meant providing documents to prove identity may well ‘help the process’. However, guidelines maintain that if a practice were to ask one patient, it has to ask all, so not to risk discrimination, and ultimately even in the event that documentation cannot be produced, patients still have to be registered.

NHS England insists the guidelines are not a change in regulations but simply ‘clarifies the rights of patients and the responsibilities of providers’ after evidence revealed ‘an increasing number of patients found it difficult to register with some GP practices’ because they were unable to prove who they are or where they live.

The guidance outlines that GP practices can only refuse a patient for registration if ‘the commissioner has agreed that they can close their list to new patients’, if they ’live outside the practice boundary’ or ’if they have other reasonable grounds’.

It admits that ’in practice, the GP practice’s discretion to refuse a patient is limited'.

Patients who fall in to the above category include: people fleeing domestic violence staying with friends or family; people living on a boat, in unstable accommodation or the homeless; people staying long term with friends but who aren’t receiving bills; people working in exploitative situations whose employer has taken their documents; people who have submitted their documents to the Home Office as part of an application; people trafficked into the country who had their documents taken on arrival; children born in the UK to parents without documentation.

The clarification arrives as the Department of Health is preparing to discuss the possibility of extending charging for NHS services from overseas patients, which could include being charged for accessing GP services.

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