Practices have raised concerns about the Register with a GP surgery service because it fails to capture information about a patient’s gender status or sexual orientation.
The online tool aimed at simplifying the patient registration process was made compulsory for all practices in England to adopt by the end of October this year.
However, the standardised form used to gather patient data isn’t fit for purpose, say some GPs, who are worried that having incomplete information will compromise care for LGBTQ patients and risk widening health inequalities.
Dr Luke Gutjahr, a salaried GP in Tower Hamlets, London, has been lobbying for a change from NHS England for more than six months, working on behalf of the borough’s 32 practices.
He told Management in Practice: ‘The form that has now been made mandatory doesn’t collect information about patients’ gender status or sexual orientation. The only question it asks is – what is your sex as recorded on your NHS record?
‘However, our current NHS system has no way of telling us if a patient’s gender identity corresponds with their birth gender. This means without explicitly asking we cannot identify this population.
‘This is not safe practice. Transgender and non-binary patients have a unique set of health needs and screening needs that are not met without knowing their gender status.’
He added: ‘It is well documented that LGBTQ people have poorer health. There are significantly higher levels of mental health issues and being LGBTQ is a recognised risk factor for suicide, depression and anxiety.
‘Collecting this information means we can target resources at this population, risk assess, make appropriate decisions and manage some of the inequalities at a populations level.’
Dr Gutjahr, who has a special interest in LGBTQ health inequality, and says that practices in Tower Hamlets are currently undergoing training as part of the Pride in Practice scheme to improve the care they offer, explained the wider significance of excluding more targeted questions at point of registration.
‘For the LGBTQ community, which is often discriminated against, being seen is important. When we fail to collect this information at the earliest opportunity, the perception of us as GPs is that we are playing our part in a society that does not see or respect this community.’
Dr Gutjahr said it is currently left to GP practices themselves to collect information on gender status or sexual orientation, so they can pick up on an individual’s needs.
But he argues, ‘changing the national registration form would save considerable GP resources’.
‘I think the uptake and general enthusiasm of the Register for my GP Service process would be greatly improved by GPs knowing this data is being collected’, Dr Gutjahr added.
‘I have emailed NHS England several times, which has said the issue is important. I have also flagged concerns with the LGBT foundation, which provides the training for the Pride in Practice scheme.’
A spokesperson for NHS England said practices can capture the data they want by using a new online tool that enables them to add any of their own supplementary questions as a follow-up.
The spokesperson said: ‘The online GP registration service makes it easier for patients to register with a GP by answering a few simple questions. We have added some optional questions to the service which GP practices can choose to add, along with a new online tool which allows practices to ask patients further questions after they’ve registered.’
For more information on how practices can add extra questions, see here.
