Majority of GP practices have ‘no out-of-area patients at all’, says NHS England

The Government’s flagship out-of-area registration scheme continues to have very low take-up with traditional GP practices.
 
NHS England has said that ‘most practices have no out-of-area patients at all, and those that do tend to have them in small numbers’.
 
Under the policy, practices can register patients who live outside of the practice boundary area without having to provide home visits.
 
NHS England data showed that 90% of practices have fewer than 10 patients registered under the scheme, with the vast majority having no out-of-area patients at all.
 
In total, ‘approximately 99,000 patients have taken the opportunity to register in this way’, NHS England said, although this includes tens of thousands of patients who have signed up with Babylon’s GP at Hand app.
 
NHS England said it has seen ‘many more patients registering under the out-of-area provisions’ since the entry of ‘digital-first models’, which are ‘not as geographically limited as traditional general practice’.
 
It added: ‘Mass out-of-area registration was not foreseen when the policy was created, being mainly focused on providing choice for commuters to register with a practice near work, and allowing patients that move a short distance to retain continuity with their existing GP by staying registered with them.’
 
GP at Hand uses the scheme to register patients to Dr Jefferies and Partner, a GP practice in Fulham in southwest London, and has attracted over 30,000 patients since its November launch.
 
NHS England’s data on out-of-area registrations were presented in its briefing note outlining the background to its ongoing consultation on GP contract reform aimed at enabling ‘full adoption’ of ‘digital’ primary care models. 
 
The out-of-area registration – or GP Choice – scheme launched on 5 January 2015, having been delayed by NHS England due to BMA concerns regarding patient safety when they needed home visits.
 
Indeed, NHS England was forced to enlist out-of-hours GP providers to provide home visits for out of area patients because too few GP practices signed up to an enhanced service aimed at filling the function.
 
Our sister publication Pulse, where this story was first published, also revealed that NHS 111 was advising patients using the scheme to go to A&E for urgent care, rather than to GP practices signed up for the enhanced service.