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New Patient Registrations

Legislation

Under the terms of their primary medical services contracts, GP practices cannot refuse an application to join its list of NHS patients on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

Other than that, they can only turn down an application if:

  • the commissioner has agreed that they can close their list to new patients,
  • the patient lives outside the practice boundary ;or
  • if they have other reasonable grounds

In practice, this means that the GP practice’s discretion to refuse a patient is limited.

Legal Advice - Requesting information from patients

When applying to become a patient there is no regulatory requirement to prove identity, address, immigration status or the provision of an NHS number in order to register. However, there are practical reasons why a practice might need to be assured that people are who they say they are, or to check where they live, so it can help the process if a patient can provide relevant documents. There is however no contractual requirement to request this, and nor is establishing an individual’s identity the role of general practice.

Any practice that requests documentation regarding a patient’s identity or immigration status must apply the same process for all patients requesting registration.

As there is no requirement under the regulations to produce identity or residence information, the patient MUST be registered on application unless the practice has reasonable grounds to decline. Registration and appointments should not be withheld because a patient does not have the necessary proof of residence or personal identification. Inability by a patient to provide identification or proof of address would not be considered reasonable grounds to refuse to register a patient.

If a practice suspects a patient of fraud (such as using fake ID) then they should register and treat the patient but hand the matter over to their local NHS counter-fraud specialist or report online via the following link

https://www.reportnhsfraud.nhs.uk/

Homeless Patients

Homeless patients are entitled to register with a GP using a temporary address which may be a friend's address or a day centre. The practice may also use the practice address to register them if they wish. If possible practices should try to ensure they have a way of contacting the patient if they need to (for example with test results).

Care Quality Commission - GP Mythbuster 29; Looking after Homeless Patients in General Practice

Who can register for free primary care services?

A patient does not need to be "ordinarily resident" in the country to be eligible for NHS primary medical care –this only applies to secondary (hospital) care. In effect, therefore, anybody in England may register and consult with a GP without charge.

Where a GP refers a patient for secondary services (hospital or other community services) they should do so on clinical grounds alone; eligibility for free care will be assessed by the receiving organisation.

It is important to note that there is no set length of time that a patient must reside in the country in order to become eligible to receive NHS primary medical care services.

Therefore all asylum seekers and refugees, students, people on work visas and those who are homeless, overseas visitors, whether lawfully in the UK or not, are eligible to register with a GP practice even if those visitors are not eligible for secondary care (hospital care) services.

The length of time that a patient is intending to reside in an area dictates whether a patient is registered as a temporary or permanent patient. Patients should be offered the option of registering as a temporary resident if they are resident in the practice area for more than 24 hours but less than 3 months.

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