Exclusive: Half of PCTs allow open-but-full lists

Open-but-full practice lists are still operating in about half of PCTs in England despite DoH demands to eradicate them, a GP investigation has revealed.

Practices that are open but full do not have formally closed lists, but only accept registrations on a limited basis, such as patients allocated by the PCT or family members of existing patients.

The DoH says there is ‘no legal basis' for open-but-full lists and has demanded that they are discontinued.

But in at least one PCT, nearly one in three practices are designated as open but full.

Medway PCT, in Kent, told a GP survey that 20 out of its 68 practices have open-but-full lists.

Other trusts are also affected. Thirteen out of 64 practices in Leicester City PCT, and 11 out of 65 practices in East Lancashire PCT are open but full.

Responses from 63 of the current 152 PCTs suggest that around one in 30 practices nationwide are in this position.

A total of 112 practices in the 63 PCTs were open but full. A further 73 were reported as having formally closed lists.

The GPC welcomed PCTs' acceptance of open-but-full status. GPC negotiator Dr Richard Vautrey said: ‘PCTs are taking a pragmatic approach to this. They recognise that some practices are unable to take on unlimited numbers of patients, often because of premises constraints.'

A DoH spokesman admitted that some practices face ‘short-term problems' with capacity that could stop them accepting new patients.

But he said: ‘The DoH made its position on open-but-full lists crystal clear in the White Paper ‘Our Health, our care, our say'. Under the new contract, GP practices' lists are now either open or closed.'

The DoH aimed to increase GP numbers and bring in new providers to tackle the shortfall, he said. It had hoped to abolish open-but-full lists by April 2007 in GMS contract negotiations, but talks have stalled.

The DoH spokesman said there were no plans to penalise practices or PCTs over open-but-full lists.

However, some PCTs have said they may strip enhanced services from practices with long-term open-but-full lists - effectively treating them as closed. But Leicester City PCT said it allowed practices with closed lists to maintain enhanced services.

Policies on how to handle the issue are inconsistent across England. Some PCTs insist the GP contract does not allow practices to be open but full.

A spokeswoman for Bradford and Airedale Teaching PCT said: ‘Open but full does not exist in the terms of the new GMS or PMS contract regulations.'

She said the PCT would use ‘all appropriate means' to ensure patients have access to GP lists.

But a spokeswoman for East Lancashire PCT said open-but-full status ‘allows GPs to manage their own list and use it to regulate the number of patients they can handle, thereby ensuring that the best level of quality service'.


  • Nearly half of PCTs allow open-but-full lists.
  • In some areas 30 per cent of practices have open-but-full lists.
  • One in 30 English practices are open but full.
  • PCTs disagree over whether open-but-full lists can be operated under GMS or PMS.


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