Practice boundaries widened and commuters can register near work in 2012/13 GMS contract

Changes to the 2012/13 GMS contract will give patients in England more choice over which GP they see, NHS Employers and the BMA have announced.

Mr Lansley: widened practice boundaries will bring patients more choice around their GP services
Mr Lansley: widened practice boundaries will bring patients more choice around their GP services

Changes to the GMS contract, announced on Wednesday, revealed plans to widen practice boundaries and pilot a scheme allowing patients to register with practices near where they work.

GPC deputy chairman Dr Richard Vautrey, said: ‘Most GPs were against the complete abolition of practice boundaries because of the potential negative impact on continuity of care, so we’re pleased that we have been able to agree this alternative which will help commuters as well as patients who move out of a practice’s boundary but want to stay registered.’

The GPC and NHS Employers have agreed that practices will agree with PCTs an outer boundary where they will retain, where clinically appropriate, existing patients who have moved into the outer boundary area.

The changes will allow ‘many people, where clinically appropriate, to stay in their current GP practice even if they move home - which is important to many patients,’ NHS Employers said.

Dr Vautrey said that the practice of allowing patients who moved a short distance out of the practice boundary to stay with their original practice already happened.

‘Most practices already have patients who live outside their boundary,’ he said.

Dr Vautrey said there would be no national guidelines on the area of the wider boundary for patients who move, but it would be down to individual practices to decide.

‘The widened boundary will only apply to currently registered patients, to offer a degree of continuity of care,’ Dr Vautrey said.

A one-year pilot of two models will be run in two or three cities allowing commuters to choose to attend a number of voluntary GP practices near where they work or elsewhere.

The first model and the option preferred by the GPC, would allow patients to register with the practice as a non-registered out of area patient - as part of a modified temporary residence arrangement - allowing them to stay registered with their home practice, Dr Vautrey said.

This option would allow the two practices to communicate and ensure that if a patient was too ill to attend work, they could still receive care at home, Dr Vautrey said.

The second model, the option which the government wanted to see trialled, would allow the patients to register as an out of area patient - moving their registration from their home practice to the new practice, Dr Vautrey said.

Dr Vautrey said it is ‘likely’ that all practices voluntarily taking part in the three cities will offer patients both registration models. The three cities taking part in the pilot are yet to be announced, but Dr Vautrey said they would probably be 'where you're likely to find the most commuters'.

The funding to pay for patients who use surgeries on a non-registered basis will be capped at £2 million. The pilots will subjected to an independent evaluation organised by the DoH. The DoH have agreed that the results of that evaluation will be published.

Dr Vautrey said: ‘We should all be willing to consider the results of the pilot.’  

Health secretary Andrew Lansley welcomed the changes. He said they would bring patients more choice around their GP services.

‘Patients often tell me that they want more choice over which practice they can register with, so I am pleased that this deal allows three major pilots to be launched across England that will allow patients to register at practices away from where they live, such as near to where they work,’ Mr Lansley said.


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