Out of Area Registrations
At the LMC we receive many queries regarding Out of Area Registrations. We have listed below, the answers to some of the most frequently asked questions;
Can existing registered NHS patients who move out of area be registered as out of area patients without home visits?
Existing registered patients who move home from inside the practice area to outside the practice area may be granted continued registration by GP practices (and must if the move is within any outer boundary area). However, continuing registration would mean no change in their status, that is, home visiting duties would sill apply. This is because out of area registration with no home visiting duties can only be applied to new patient registrations. If the GP practice wishes for the new out of area registration arrangement to apply the GP practice will first need to remove the patient from the practice list (on the grounds they have moved out of area) and then invite them to register under the new arrangements (assuming the patient wished to be registered this way and it was clinically appropriate and practical) making clear the implications of these in respect of home visits etc.
Can existing registered NHS patients who live out of area be now registered without home visits obligations?
No, existing registered patients who live out of area (i.e.. those registered with the practice prior to 1 October 2014 as any other registered patient with access to home visits when needed) will continue to be registered in this way and the new arrangements do not apply retrospectively to such patients.NHS England’s interpretation of the regulations is that it would be unreasonable grounds for removing such patients from the practice list if that is with the aim of the practice seeking to release itself of home visiting duties for them and
reregistering them as a new patient under these new arrangements.
Would a practice have any obligation to visit a patient registered without home visiting obligations if they also have patients living in the same area but who are registered with access to home visits?
The contract variation ensures there is no obligation or duty on practices to visit patients who have been registered without home visiting duties. The circumstances of other registered patients do not change this because the decision to register without home visits is made on individual basis to ensure it is clinically appropriate and practical to be registered that way (For example, even family members living in the same household outside the practice area could be registered with or without home visits).
Will I be contractually obliged to see out of area registered patients as temporary residents or provide them immediately necessary treatment?
No, out of area patients are recognised as a disinct category, separate from temporary residents. The obligations on the GP practice are therefore different and there will be no contractual obligation to provide immediately necessary treatment, which should be obtained by the mechanism which has been communicated to the patient, generally involving phoning NHS 111 which will be provided with a directory of which services have been commissioned locally to meet the needs of out of area registered patients.
Can a dispensing practice dispense to out of area patients?
To be eligible for dispensing services, a patient who does not have serious difficulty getting to a pharmacy, must live within a designated controlled locality and no more than 1.6km from any pharmacy premises, excluding distance selling premises. If a patient receives dispensing services from practice A and then registers with practice B, which are both located in a controlled locality, then that patient can continue to receive dispensing services. A controlled locality is an area that has been determined by NHS England, to be 'rural in character'. If a patient does not reside in a controlled locality, but decides to register with a practice, which is a dispensing practice in a controlled locality, the patient would sill not be eligible to receive dispensing services.