Exclusive: DH forced to delay practice boundary abolition pilots

The DH has been forced to delay practice boundary pilots agreed as part of the 2012/13 GMS contract, GP can reveal.

Dr Kambiz Boomla: 'The practice boundary scheme destroys the whole notion of a CCG looking after a geographical population' (Photograph: W Fry)
Dr Kambiz Boomla: 'The practice boundary scheme destroys the whole notion of a CCG looking after a geographical population' (Photograph: W Fry)

Pilots in Manchester, Nottingham and London that will allow patients to register near their place of work were due to go ahead from 1 April.

A handful of practices have signed up to take part, but LMCs report that some are set to pull out because of a lack of guidance on how the process will work.

GP leaders have warned that the boundary pilots will incr­ease costs and undermine patient care.

A DH spokeswoman confirmed the pilots had been del­ayed and could not give a revised start date, but said that they would take place ‘post-Easter’.

Nottingham LMC repor­ted that 14 local practices had shown an interest in the pilots. Around 18 practices in Manchester and 13 in Salford and Trafford had also signed up.

In London 12 practices from Westminster, four from Tower Hamlets and one from the City expressed an interest in the scheme.

The DH said details of how the pilots would work would be set out in guidance ‘very shortly’.

Considering pulling out
But LMCs have warned that practices are considering pulling out as the original deadline draws close, and more could withdraw if they did not agree with final guidance.

Manchester LMC chairman Dr John Hughes said guidance to date on the pilot scheme had been ‘very vague’. He said the lack of information had fuelled GPs’ fears about how the pilots would be run.

He warned GPs would drop out if final guidance ‘doesn’t look wonderful’.

GPC deputy chairman Dr Richard Vautrey agreed practices could pull out. ‘Those who were enthusiastic may make the decision not to take part,’ he said.

Dr Vautrey: practices may pull out of the choice pilot

Dr Hughes expressed concern about how patient information would transfer between practices and services in different parts of the country.

‘They are talking about how the practice near the patient’s work could communicate with community services in their home town but we have huge difficulties communicating with health visitors in the next clinical commissioning group (CCG) area, never mind the other side of the country,’ he said.

City and East London LMC chairman Dr Kambiz Boomla expressed concerns that the scheme prioritised the needs of out-of-area patients above those of local patients.

‘It destroys the whole notion of a CCG looking after a geographical population.’

He said the scheme would add to NHS costs in pilot areas. ‘Practices will be paid for the patients either as day patients or as a full registration. Either way there is no funding for the hospital or CCG prescribing budget, or for the use of comm­unity services,’ he said.

Nottingham LMC vice chairman Dr Arun Tangri warned the pilots could lead to a misuse of services.

‘Someone from just outside Nottingham could decide to register with a practice in the city centre to get better services,’ he said.

Original guidance said the pilots would allow commuters to register as ‘out-of-area’ patients at practices close to their place of work.

They will also be able to register as a temporary resident, receiving a maximum of five consultations per year.

A DH spokesman added: ‘We have always previously said that we aim to give patients far greater choice of GP practice during April 2012. Detailed guidance has been developed in conjunction with the BMA and will be issued shortly.’


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