Gypsy advice may provoke GP list inflation allegations

Travellers: GPs asked to offer longer, unscheduled appointments.

NHS advice on registering patients from traveller or gypsy communities could lead to GPs being accused of inflating their list size, the GPC has warned.

The guidance says GPs should register patients from these groups as permanent residents and allow them 20-minute consultations.

It also recommends that GPs never refuse to see a gypsy or traveller without an appointment 'even if all appointments for that day are full'.

The guidance, from Primary Care Contracting, a network of NHS and DoH advisers, aims to help PCTs make services more accessible to these groups.

Romany gypsies and Irish travellers are both recognised as minority ethnic groups under race relations laws, the guidance says, meaning NHS bodies have a legal duty to consider their needs.

The guidance says it should apply to other travelling communities, listing Scottish gypsy travellers, Welsh gypsies, bargees, circus showmen and new travellers. The total UK population of these groups is estimated to be 120,000 to 300,000.

GPC negotiator Dr Chaand Nagpaul said registering travellers as permanent residents could land GPs in trouble.

'Contractually, it is not correct. GPs could be accused of signing up patients who they know are only temporarily resident in their area,' he said.

Describing the guidance as 'very strange', Dr Nagpaul said emergency appointments should be for clinical reasons.

'GPs need to treat all patients equally. They should offer appointments based on clinical priority and it would not be logical to offer special appointments to one particular community.

'This seems to be positive discrimination, and is far too prescriptive,' he added.

The guidance recommends that these 'flexibilities' are 'com-missioned from all practices' but does not mention funding.

Dr Nagpaul said if practices must provide longer consulta-tions and leave staff free to deal with unscheduled arrivals, it should be voluntary and funded via a local enhanced service.

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