New arrangements introduced from January 2015 give people greater choice when choosing a GP practice. Patients may approach any GP practice, even if they live outside the practice area, to see if they will be accepted on to the patient list.
The new arrangements mean GP practices now have the option to register patients who live outside the practice area but without any obligation to provide home visits.
Out of area registration is voluntary for GP practices meaning patients may be refused because they live out of area.
If your application is considered the GP practice will only register you without home visits if it is clinically appropriate and practical in your individual case.
When is it clinically appropriate and practical to register out of area patients without home visits?
When a patient approaches the GP practice to apply to register as an out of area patient and the practice wishes to consider their registration without an obligation to provide home visits it will need to decide whether it is clinically appropriate and practical for the individual patient.
While it is for the practice to form this opinion based on the individual circumstances of the patient, practices will want to consider, for example, if:
1. There are clinical conditions or care needs which mean registration without the ability to do home visits would compromise clinical care, and the patient’s needs would be better met through registration with a practice near to where they live. (For example, the patient has complex long-term conditions that mean they are receiving a package of home-based care or community-based support which would be difficult for the practice to coordinate remotely; or, the patient relies on frequent home visits from their current GP practice.)
2. There are practical reasons which mean the patient is unlikely to benefit from out of area registration with the practice (for example, the patient is not spending frequent periods of time in or near the practice area where they wish to register.)
Other examples of concern would be concerns around child and adult safeguarding.
If the practice decides it is not clinically appropriate or practical for the patient to be registered away from home it will give its reasons for this. There is no right of appeal for the patient against the decision (they may, however, make a complaint through the NHS complaints system as for any other decision). The practice must be able to give reasons as to why registration was declined. Given the limitations of this type of registration, it is not discriminatory to advise a patient is unsuitable for registration on clinical grounds. The practice remains free to offer registration in a usual way, as to any other patient i.e. with duty to provide home visits etc. but is not obliged to do so.
In order to decide the clinical appropriateness and practicality of the individual patient application we may :-
Ask you or the practice you are currently / was registered with (with your consent) questions about your health to help decide whether to register you in this way
Ask you questions about why it is practical for you to attend this practice (for example, how many days during the week you would normally be able to attend)
If accepted, you will attend the practice and receive the full range of services provided as normal at the surgery. If you have an urgent care need and the surgery cannot help you at home we will ask you to call NHS 111 and they will put you in touch with a local service (this may be a face to face appointment with a local healthcare professional or a home visit where necessary).
We may decide however, that it is not in your best interests or practical for you to be registered in this way. In these circumstances we may offer you registration with home visits, for example, if you live just outside the practice area, or we may not register you and advise you should seek to register (or remain registered) with a more local practice.
If accepted but your health needs change we may review your registration to see if it would be more appropriate for you to be registered with a GP practice closer to your home.
This new arrangement only applies to GP practices and patients who live in England. For further information visit the NHS Choices website (www.nhs.uk)
How do I register as an Out of Area Patient?
Please visit the practice and ask one of our reception team that you would like to register as an “out of area patient”, our team will provide you with the necessary paperwork. Alternatively, you can now apply online.