Registering with a GP: what identification is required to register with a practice in Wessex?

This report was produced by the five Local Healthwatch organisations in the Wessex region following concerns that some people were being prevented from registering with GP practices because they lacked photo identification or proof of address. The issue particularly affected vulnerable groups, including homeless people, refugees and asylum seekers, young people, older people and others who did not have standard identification documents. 

The report followed a change in national NHS guidance introduced in November 2015, which states that GP practices should not refuse registration to patients who live within the practice boundary simply because they cannot provide identification or proof of address. The guidance also warns that routinely requesting photo identification could be discriminatory. 

To assess whether practices had implemented the revised guidance, Healthwatch Southampton, Portsmouth, Hampshire, Dorset and the Isle of Wight conducted a "mystery shopper" exercise. Researchers contacted all 322 GP practices and branch surgeries across the Wessex region and asked what documentation was required to register as a patient. If a practice requested identification, researchers then explained that they did not possess the requested documents and asked whether registration would still be possible. 

The findings showed that the vast majority of practices continued to request identification. Of the 322 practices surveyed, 244 practices (75.8%) required photo identification, 42 practices (13%) required proof of address or other non-photo identification, and only 23 practices (7.1%) required no identification at all. Overall, 286 practices (88.8%) requested some form of identification before registration.

When researchers explained that they did not have the requested documents, the response from practices remained inconsistent with national guidance. Among the 198 practices included in the follow-up analysis, 147 practices said alternative forms of identification would be acceptable, 46 practices continued to insist on photo identification, and five practices said the matter would need to be discussed with the practice manager. 

The report concluded that, despite the national policy change, many GP practices either appeared unaware of the revised guidance or had not fully implemented it. Researchers expressed concern that patients could mistakenly believe identification was compulsory and therefore choose not to register with a GP, potentially limiting access to essential healthcare services. 

Wessex Voices recommended that all practice staff, including reception and administrative staff, receive training on the 2015 registration guidance. The report also suggested that practices either stop routinely requesting identification altogether or clearly explain that ID is preferred but not required. In addition, practices were encouraged to update their websites, registration materials and printed information so that patients understand they can register even if they do not possess proof of identity or address.

Overall, the report found a significant gap between national policy and local practice and warned that existing registration procedures could unintentionally exclude vulnerable people from accessing primary care services to which they are entitled.