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Vulnerable patients blocked from accessing GPs due to lack of ID, reveals report

by Léa Legraien
22 August 2019

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Vulnerable patients have been denied their right to register with a GP bacause they don’t have ID, according to a new report.
report released this week by medical charity Doctors of the World (DOTW) found that almost a fifth (19%) of 2,189 attempts to register new patients across 990 GP practices last year failed due to patients’ inability to show paperwork such as ID and proof of address.
The findings go against NHS England guidance issued in November 2015, which clarified that all asylum seekers, refugees, overseas visitors – whether lawfully in the UK or not – as well as students, people on work visas and those who are homeless, are ‘eligible to register with a GP practice’.
This follows research that showed patients who do not have a fixed address, including those in the traveller community, experience greater GP access issues than others.
‘Worrying’ registration policies
The report’s findings were discussed at City Hall, where DOTW highlighted ‘worrying GP registration policies which discriminate against some of the most vulnerable people in our community’.
According to the report, in nearly two thirds of the cases (64%) patients were refused registration after they failed to show their ID or a proof of address.
The charity also found that:

  • 13% of practices refused every attempt to register a DOTW patient and a further 17% gave inconsistent responses, demonstrating patchy understanding among frontline staff of entitlement rules.
  • 30% of the 990 GP practices approached refused at least one registration attempt. Most of these (87%) were rated as ‘Good’ or ‘Outstanding’ by the CQC.
  • Three quarters of the practices approached were in Greater London. Refusing practices were more likely to be located in more deprived boroughs, with 37% of total refusals concentrated in London’s five most deprived boroughs, but these also had higher numbers of DOTW registration attempts.

‘Stark health inequalities’
DOTW director or programmes Lucy Jones said: ‘The NHS was funded on principles of equality and non-discrimination and it’s better for everyone that the most vulnerable in our communities can see a GP. Yet unnecessary immigration and paperwork in GP surgeries are stopping people from getting the healthcare they need.
‘One fifth of our attempts to register patients with GPs are wrongfully refused. This is already worrying. However, we know that when vulnerable patients approach GP practices themselves, a successful registration is even less likely. So it’s great to see that practices and leaders in the sector are working to make their services more accessible for all.’
Mayor of London health advisor Dr Tom Coffey OBE said: ‘The difficulties the most disadvantaged Londoners face when registering for a GP expose the stark health inequalities across our capital. Everyone should have easy access to a GP, yet this again shows that the health of Londoners is being profoundly shaped by who you are and where you live.
‘The Mayor is taking bold steps to make London a healthier, fairer city, and we need the Government and everyone across the health and care service to do all they can to tackle these health inequalities in the long term.’