Practices to be paid £16 per appointment for out-of-area patients

Practices will be awarded £15.87 per in-hours GP consultation and £60 per home visit for patients registered away from where they live, under the out-of-area registration DES.

Consultation: £16 per visit for out-of-area patient (Photo: JH Lancy)
Consultation: £16 per visit for out-of-area patient (Photo: JH Lancy)

The enhanced service, designed by NHS England, will support the updated choice of GP practice arrangements that will be introduced from 5 January 2015.

From this date, all practices will be able to register patients who live outside of their traditional boundaries, without being required to provide home visits or out-of-hours care.

Practices will not be obliged to participate in the scheme, and will remain able to refuse registrations from out-of-area patients. They will also not be obliged to offer home visits for patients registered elsewhere.

The GPC warned it had 'lots of concerns' about the plans and said practices would have to 'carefully consider' whether the remuneration on offer was 'enough to cover their costs'.

200,000-patient forecast 

NHS England expects around 0.4% of the population – 200,000 people – to register with a practice outside of their local area, ‘although this might grow over time’.

Any patient who requires ‘urgent and local care’ and cannot reasonably travel to their out-of-area practice will be able to access primary medical services nearer their home, under the new enhanced service.

Practices participating in the DES will be expected to provide home visits to registered out-of-area patients in their appointed boundary area, where it is clinically required.

If any practice chooses not to sign up for the DES, neighbouring practices that have signed up may have to provide services for wider areas.

In such circumstances, national pricing does not apply and would be ‘agreed locally’, NHS England said.

Review after 12 months

Patients registered out-of-area will be given a review to decide whether it would be more appropriate for them to be registered with a practice nearer their home, should they arrange at least four consultations under the DES within a 12-month period.

This will also be triggered if they receive two home visits within the same period.

GPC deputy chairman Dr Richard Vautrey said: ‘There is absolutely no obligation for practices to have anything to do with this at all, either in registering out-of-area patients or in providing a service to those who cannot get to their newly registered practice.'

He added: 'Those practices that have lost patients, but are then invited to look after them again when they are too sick to travel to their new practice, will have understandable concerns about doing so.'

Only practices that currently maintain an open list will be eligible to sign up to the DES. Existing GP health centres and walk-in centres that already provide unregistered patient services will be ineligible.

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