GP backs practice boundary abolition but wants power to refuse patients

The DoH should push ahead with plans to remove practice boundaries but must allow GPs to refuse patients if it is logistically complex to take them on, a senior GP has said.

Dr Kingsland: ‘If patients are so far logistically removed and arrangements are complex it would not be in patients’ best interest I would want to be able to say no.’
Dr Kingsland: ‘If patients are so far logistically removed and arrangements are complex it would not be in patients’ best interest I would want to be able to say no.’

Talking to GP, DoH national clinical commissioning network lead for England Dr James Kinglsand said practice boundaries should be removed despite some concerns from the profession.

He said patient choice must be ‘paramount’ and patients must have flexibility in their choice of GP practice.

But Dr Kingsland said there should be ‘some arbitration’ to allow GPs to refuse patients if it is logistically difficult to take them on to their lists.

He said: ‘I would want the ability for general practice to have some choice themselves.

‘If patients are so far logistically removed and arrangements are so complex it would not be in patients’ best interest I would want the ability to say no.’

He said the NHS Commissioning Board, or whoever holds GP contracts, would act as the arbitrator. But he said the decisions about whether to take on patients would not be an exact science.

‘We need to give patients choice and not remove them from our lists just because they move across a border.

‘But we need to get the principles and logistics right. There is no right or wrong answer.’

It echoes comments made earlier this year by Conservative Medical Society chairman Dr Paul Charlson who said GPs should be able to refuse patients with no link to a local area once practice boundaries are removed.

But GPC deputy chairman Dr Richard Vautrey said this would be a ‘recipe for disaster’ as it would leave GPs open to accusations of discriminatory behaviour.

He said: ‘The risk of practices being accused of accepting one type of patient not another would place them in serious legal jeopardy. This is not the way we would want general practice to go.’

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