Barriers to GP registration in Haringey

Healthwatch Haringey and Haringey Welcome partnered with the NHS, Haringey Council and Doctors of the World to find out how many Haringey GPs would accept a patient without ID.

They called 39 surgeries in the mystery shopping telephone survey:

• 24 out of 39 said they needed to see proof of address.
• 30 out of 39 surgeries said they needed to see ID.

37 surgeries were visited in person:

• 20 out of 37 required proof of address.
• 20 out of 37 required ID.

When Healthwatch called saying they were Healthwatch Haringey, only two surgeries who had initially asked for documents subsequently clearly answered that they would register a patient without documents if the patient couldn’t provide them.

The report looks at other barriers to GP registration: When mystery shoppers visited Haringey surgeries, they found four who would only allow online registration, meaning that people who could not access a smart phone or computer were excluded.

The in-person mystery shoppers found only 11 surgeries offered any kind of help with filling in the registration form, such as interpreting or translating the form into a community language or offering help from staff who could speak the patient’s language.

 Healthwatch sometimes found it difficult to get through on the phone. They waited over 20 minutes for a member of staff to answer the phone at seven surgeries.

Healthwatch discovered a complex and interlocking system of barriers behind the refusal to register, including contradictory NHS guidance; inadequate support for frontline staff, including administrative barriers in the NHS system; the ‘hostile environment’ including concerns about ‘deservingness’ for some groups; concerns that patients without documents are more burdensome or that there is a risk of fraud; concerns about patient safety; and an overarching lack of resources in the NHS, particularly a lack of staff charged with reception duties and the consequent unmanageable workloads.

Nevertheless, Healthwatch also found some very good practice: Inclusive registration policies and helpful and friendly reception staff, ready to welcome new patients in.

The report contains two recommendations.  Healthwatch Haringey have co-produced resources with our Partners which they are distributing to our communities, carrying the message that you have a right to register with a GP, even if you don’t have documents.