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Low patient interest in practice boundary pilot

20 March 2014

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Results of the government’s practice boundary pilot scheme only showed “modest” demand for the service, it has been revealed. 

The Department of Health’s Choice of GP pilot scheme found that participants were generally positive about the scheme and there was “little sign of major increased cost” to primary care trusts (PCTs) but interest in the scheme was low. 

Patients will be able to register with volunteer practices outside the area where they live throughout England from October 2014.

Volunteer practices in Westminster, Salford, Manchester and Nottingham City allowed patients to register as an ‘out of area’ patients for 12 months from April 2012. 

A total of 43 practices participated in the pilot, published today by the London School of Hygiene and Tropical Medicine, with approximately half of the practices in Westminster.  

But 11 of the 43 pilot practices recruited no patients during the 12 months of the pilot.

Patients in the pilot could also be seen as a ‘day patients’ while remaining registered with their original practice, however, this option will not be included when the scheme is rolled out.

The scheme was most popular in Westminster, where 71% of the pilot’s 1,108 patients were based. 

Overall, the pilot found that Westminster patients were much younger, more likely to have better self-reported health, more likely to be in work, and twice as likely to have more than a 30-minute commute than other patients in the pilot areas.

There were four types of ‘out of area’ registered patients; patients who had chosen their new practice for convenience, for example, because it was close to their work (32.6%), patients who had moved house but did not want to change their practice (26.2%), patients who were new to the area and had registered with a pilot practice but lived outside the practice’s catchment area (23.6%) and patients who were dissatisfied with their previous practice or chose their new practice for specific services or to see a particular GP (13.9%).

Lead author Professor Nicholas Mays from the Policy Innovation Research Unit at the London School of Hygiene & Tropical Medicine, said: “While demand for the pilot was modest, our evaluation found that patients had positive views of the scheme because, for example, they didn’t need to take time off work to visit a GP or they were able to continue care with a doctor they had a longstanding relationship with after they moved house.

“Our findings suggest that the extension of the scheme across England later this year will appeal to a minority of the population who have these needs and in particular parts of the country.”

“However, we need to bear in mind that the pilot was only for 12 months and only in four areas of the country, so it is difficult to know precisely how the scheme will work on a larger scale and over the long term.” 

Health Minister Lord Howe said: “Our recent changes to the GP contract will help patients choose a GP practice to suit them. This will support hardworking people who commute to work and cannot access their local surgery during opening times, and enable people who move house to stay with their GP if they want to.”

However, the researchers did warn that the year-long pilot may not be long enough for any potential drawbacks to become apparent, including issues related to receiving out of hours care while registered at a practice far from their home.

The independent evaluation was commissioned by the Department of Health on behalf of NHS England through its Policy Research Programme, as part of the core research programme of the Policy Innovation Research Unit at the London School of Hygiene and Tropical Medicine.