Vulnerable patients often denied GP registration, report finds

GP practices regularly turn away vulnerable patients who have a right to register with them, research by a leading medical charity shows.

GP registration (Photo: Mike Kemp/Corbis News/Getty Images)
GP registration (Photo: Mike Kemp/Corbis News/Getty Images)

Doctors of the World (DOTW) UK clinics support more than 2,000 patients a year, most of whom are vulnerable migrants living in poverty. Patients not registered with an NHS GP who attend a DOTW UK clinic are supported by a caseworker to sign up with a practice if they wish to do so.

Records kept by the charity show that in 2,189 attempts to register patients with a GP practice in 2018, patients were incorrectly turned away in one in five cases. DOTW UK says that when patients try to register independently with GP practices, the rate of refusal is even higher.

Guidance published in 2015 by NHS England makes clear that any person can register and consult with an NHS GP for free, and that there is no regulatory requirement to prove identity, address, immigration status or to provide an NHS number to do so.

GP registration

Despite this, lack of paperwork was cited in two thirds of cases in which practices refused to register patients supported by DOTW UK. In 28 cases (7%), patients' immigration status was cited as a reason why registration was refused, while lack of proof of address was cited in 29% of cases and lack of proof of ID in 49% of cases.

A report on the findings, called 'Registration refused', says: 'NHS England guidelines, in interpreting GP services’ duties in relation to equalities and non-discrimination, protect the right to GP registration for those who are not able to provide proof of address or identification.

'However, our findings demonstrate that many GP practices are failing to implement these principles and, as a result, vulnerable patients are facing worrying obstacles and unnecessary delays to primary care access.'

Lucy Jones, director of programmes at DOTW UK, said: 'The NHS was funded on principles of equality and non-discrimination and it's better for everyone that the most vulnerable in our communities can see a GP.'

Vulnerable patients

But she added: 'One fifth of our attempts to register patients with GPs are wrongfully refused. This is already worrying. However, we know that when vulnerable patients approach GP practices themselves, a successful registration is even less likely.'

Three quarters of the 990 practices approached by the charity on behalf of patients seeking to register with a GP were in the London area.

London GP Dr Tom Coffey, a health adviser to London Mayor Sadiq Khan, said: 'The difficulties the most disadvantaged Londoners face when registering for a GP expose the stark health inequalities across our capital.

'Everyone should have easy access to a GP, yet this again shows that the health of Londoners is being profoundly shaped by who you are and where you live. The mayor is taking bold steps to make London a healthier, fairer city, and we need the government and everyone across the health and care service to do all they can to tackle these health inequalities in the long term.'

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