Research published by humanitarian charity Doctors of the World (DOTW) has found that as many as one in five pregnant women, children, homeless people, refugees and other vulnerable members of the public are being refused registration at GP practices across England due to a lack of administrative and clinical staff training.
Of 1,717 attempts made by DOTW to register a patient with a GP in 2017, 20% were refused, the research shows.
Everyone in the UK is entitled to free primary care and NHS England guidelines protect the right to GP registration for individuals who do not have proof of address or identification at their disposal. However, DOTW said that a lack of ID or proof of address were cited as the most common reasons for refused registration - affecting over two thirds of attempts.
Dr Peter Gough, GP and DOTW clinic volunteer told GPonline: ‘We recognise that primary care staff are struggling to manage heavy workloads and there is a great deal of misinformation being spread about primary care entitlement. However, many practices have shown that it’s possible to implement registration policies that are considerate of the needs of migrants in vulnerable circumstances.
‘A comprehensive training programme for clinical and non-clinical staff is needed nationally, which covers healthcare entitlement, barriers faced and the health needs that are common to migrants in vulnerable circumstances.’
Although the majority (70%) of the 858 GP practices approached as part of the study agreed registration on every attempt, 14% were inconsistent in their responses. Additionally, one in five (16%) were refused registration on every attempt, suggesting a significant degree of confusion among GP and practice staff over the healthcare entitlement guidelines.
Access to healthcare
To help GP practice staff provide a safe and accessible services to everyone in their community without increasing workload, DOTW UK has launched a 'safe surgeries' initiative. Becoming a safe surgery equips practices with access to training, tailored resources and a supportive national network of practices committed to tackling the barriers preventing vulnerable people from accessing health services.
Dr Gough added that ‘more NHS-led initiatives would have real value’, but in the meantime reccommends that practices take straightforward steps to accommodate vulnerable patients.
‘Accommodating for individuals who don’t have proof of address or identification, never asking to see immigration documents and using an interpreter, can make a huge difference,’ he said.
GPC chair Dr Richard Vautrey said: 'Everyone in England should be able to register with a practice and it is particularly important that vulnerable patients, who may have specific healthcare needs related to their situation, are not put off from accessing primary healthcare.
'We have provided guidance to practices that despite suggestions by some bodies, practices do not need to request ID to register any patient.'