Registering
Contents
Registering with the
Practice
Choice of
Practitioner
Registering with the Practice
Anyone who is resident in the UK
is entitled to the services of an NHS GP. When a patient registers
with a practice they gain access not only to a GP but to a large
primary health care team, including administrative staff, practice
nurses, health visitors, district nurses, and perhaps a social
worker. Registration is also a gateway to specialist care via
referral.
Patients have the choice to
register with any NHS surgery in the area where they live.
Surgeries advertise their catchment or “practice area” by reference
to a sketch diagram, plan or postcode in their practice leaflet.
Practices are also required to provide treatment for unregistered
patients who are temporarily away from their normal place of
residence; or require immediately necessary treatment due to an
accident or emergency in the practice area.
Practices have the discretion to
accept or refuse to accept patients onto their list, as long as
they have reasonable grounds for doing so (see guidance
below).
The Government has made a
commitment that, by 2007/08, patients will be guaranteed acceptance
onto an open list in their locality and that the registration
process will be simplified and streamlined. The concept of an “open
but full” list will end, and the existing closed list procedures
will be made simpler to operate, in order to provide greater
transparency for patients. PCTs will be obliged to provide
authoritative information to the public on whether a practice is
open for new patients, the range of services it provides, and its
opening hours.
Choice of Practitioner
Patients now register with a
practice rather than an individual GP, but can name a preferred
practitioner, which will be noted in the patient’s medical record.
This is particularly important for patients who value seeing a
practitioner of their choice for the purposes of continuing care,
care of particular conditions, gender or ethnicity.
Choice to see a specific
practitioner is not absolute, but depends on availability and
appropriateness. Where a patient wishes to exercise this right they
may have to wait longer to see their preferred practitioner.
Additionally the patient may be asked to accept an alternative if,
for example, the service required is now being delivered by another
professional member of the practice.
Top of Page 
New Patients
New patients registering with a practice are invited within six
months to make an appointment for a health check, generally
conducted by the practice nurse. The purpose of this health check
is to collect information about personal and family medical
history, and to ensure that all routine preventative measures are
up to date, such as smears and blood pressure measurement.
Top of Page
Removal of Patients from Lists
The law allows a GP
practice to remove a patient from its list under certain
circumstances. This usually occurs when the relationship between a
practice and a patient suffers an irreconcilable breakdown, and is
seen as a last resort when other options have been exhausted.
GP practice leaflets should
outline both the patient removal policy and the circumstances that
might lead to its implementation. Removal from a list will follow a
transparent process that would normally include a warning to
the patient. Practices are required to give specific
reasons as to why the removal has occurred, though in certain
circumstances a statement to the effect that the relationship
between the patient and the practice has irrevocably broken down
will suffice (see RCGP guidance below). The General Medical Council
advises doctors to inform the patient orally or in writing why they
have ended a professional relationship and ensure arrangements are
made for the continuing care of the patient and the handover of
records
Patients can apply for
registration with a different practice if that is their preference.
Patients who decide to leave a practice list should give their
reasons for doing so to the practice manager, as this may help
to improve future care provision.
The circumstances leading to the
removal of a patient from a GP list are often complex. Guidance has
been prepared by the Patient Partnership Group of the
RCGP listing the type of circumstances in which a patient
removal would be appropriate and those in which this would be an
unacceptable action.