Greenwich GP Access report 2017

According to the findings of a research by the Royal Borough of Greenwich, an estimated 1.2 - 5.4% of the Greenwich population were not registered with a GP. One concern was that even though it did not comply with NHS England guidance, the GP practices were requesting, in some cases, passports/photo ID as well as 2 proofs of address when registering, which some homeless and immigrant status patients were unable to provide. Some practices were also identifying and de-registering ‘ghost’ patients (those not used the GP for 5 years or more) in the effort to cleanse their list. As a result, this was limiting the amount of people that could attend the GP Access Hubs which replaced walk in centres. This in turn was placing pressure on the Accident and Emergency and Urgent Care Centre, as that is where they would eventually go.

Besides the GCCG’s effort, in 2015, to spread awareness through a GP registration campaign which produced a leaflet saying “immigration status does not affect your right to register with a GP, in fact you shouldn’t even be asked” after concerns some black and minority ethnic (BME) residents were reluctant to register because of their immigration status, HW Greenwich conducted an audit between January and March 2017, in which HW staff and volunteers phoned all 48 GP practices to find out about the information needed for registering. HW also carried out an audit of the GP websites to identify any advice and guidance provided about registering with them. They found that apart from Vanbrugh Group Practice, all other practices requested some form of registration documentation, ranging from passport identification to two forms of proof of address. 46% of practices requested proof of identity. 26% practices requested two proofs of address. 24% practices requested one proof of address.

Although most practices had a link on their website to download the registration form, none of them had any information about patient’s rights to registering without documents, or immigration status not being required. Although no practices requested immigration status documents to register, 32 of the practices did request passports or photo ID. Despite no evidence that administrative staff were making decisions to register on their legal status, this requirement could act as a significant deterrent to many people.

HW reports that 58% of the GPs administrative staff were either unsure or asked to refer to the practice manager to confirm when a person can at all register without documentation. 31% of the practices stated they could register patients without any proof of address or form of identification, only after referring to the practice manager. One practice positively stated to this question that they “can and must register...and would never turn anyone away”. Overall, the report findings indicate that despite these efforts, many Greenwich GP practices are still not adhering to the patient registration guidance provided by the NHS, CQC and other professional bodies. Based on the findings, several recommendations were proposed, and the service providers responded individually some finding the report ‘informative’ whiles others explaining their policies.