Safe surgeries - GP registration for vulnerable groups

Healthwatch Waltham Forest undertook a survey to evaluate how accessible GP surgeries are for vulnerable groups, such as migrants and those without regular identification or proof of address.  They also mystery shopped GP websites.

The average time to answer a call ranged from 2 to 6 minutes. Some surgeries required 3 call attempts before connecting.

The survey found that 78% of GP surgeries required photo ID and/or proof of address to register. This can serve as a barrier to vulnerable groups, thus failing to meet the Accessibility pillar of the Good Care Framework, which advocates for the removal of such obstacles. 

The inconsistency in registration policies (e.g., some practices requiring ID while others do not) may reduce trust in the system. This inconsistency can be particularly challenging for refugees, asylum seekers and undocumented migrants, who may have an inherent distrust of authority due to past experiences with government agencies. For these individuals, navigating unclear or overly strict requirements can amplify fears, reducing their willingness to seek essential care. Patients need to feel confident that they can access care without unnecessary barriers or bureaucratic hurdles. 

The framework emphasises that patients should be treated with understanding of their specific circumstances and of the reasons why they cannot provide the same kinds of documentation as other practices. Practices that offer alternatives for those lacking documentation show a more person-centred approach, while those that turn away vulnerable patients fall short. 

 Ensuring reception staff are trained to follow NHS guidelines and offer flexible solutions (e.g., allowing alternative documentation) aligns with the Competent pillar. Practices that do not follow this risk creating barriers to care, indicating a need for better staff training.