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Inclusive patient registration is hindered by financial disincentives, study says

by Beth Gault
16 December 2022

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Removing financial disincentives would help remove reluctance to register patients that have no documentation, a study has suggested.

The BJGP study, which interviewed 33 GP staff in North East London, looked at the reasons behind practice staff refusing to register transient patients that have no documents – even though NHS England guidance states that such everyone in England can register with a GP, regardless of immigration status, and that they do not require documentation or an NHS number to do so.

The research found that although staff were aware of this fact, there were a number of concerns that put barriers in the way. These were mainly around the administrative and financial burden placed on health services by registering patients with no documents, as well as fears as about safeguarding with respect to the patient themselves, staff and others (for example, if ‘red flags’ were missed because the practice didn’t have access to full records).

The study said: ‘Participants highlighted that those without documents were more likely to need translation services, and therefore double appointments, increasing costs to the practice.

‘Additionally, it was felt they were likely to be difficult to contact, or move out of the area, making it more challenging to achieve Quality and Outcomes Framework (QOF) targets.’

The study concluded that staff concerns and high workloads need to be addressed to help improve inclusive registration practices.

It said: ‘The perceived practical and financial burdens relate to overall increases in workload and the current funding model utilised in general practice. Initiatives to improve access must acknowledge such concerns.’

It comes after patients are now able to register with a GP practice remotely, in an effort to make the process more inclusive and tackle issues which contribute to health inequalities.