Healthcare experts address inequalities in primary care access in London

Published 20th August 2019

20th August, London – Leading NHS and charity sector experts meet at City Hall to discuss how to tackle inequalities in primary care access, in the context of a new report by medical charity Doctors of the World which sheds light on worrying GP registration policies which discriminate against some of the most vulnerable people in our communities.

Everyone living in the UK is entitled to see a GP free of charge. This is the most effective and efficient means of preventing ill-health and promoting well being. Despite this, people in need of healthcare are wrongly turned away from GP practices in England every day.

Doctors of the World (DOTW) UK’s Registration Refused reporting (2016-2018) monitors the wrongful GP registration refusals of their patients, most of whom are migrants in vulnerable circumstances who are living in poverty. Registration Refused 2018 shows that almost one fifth of attempts by Doctors of the World’s volunteers to register patients with a GP were wrongly refused, for reasons that contravene NHS England guidance.

Lack of paperwork (proof of ID or address) was the most common reason for refused registration – accounting for 64% of cases – and is likely to disproportionately affect already vulnerable groups. Thirty percent of GP practices approached (299 of 990) refused at least one registration attempt. Almost all of these (n=256; 87%) were rated as ‘Good’ or ‘Outstanding’ by the Care Quality Commission (CQC).

The prevalence of this issue has worrying implications both for public health and the health and safety of people in need, including people who are homeless, migrants in vulnerable circumstances and survivors of trafficking and modern slavery.

The event at City Hall will take place under the umbrella of the Safe Surgeries initiative, which aims to improve access to primary care by supporting providers to offer more welcoming and inclusive services. Practices that join are part of a supportive network of GP practices who are committed to delivering inclusive and accessible services for everyone in their communities, and can access free training and practical resources.

Panel discussion will explore the question of “What should an inclusive primary care system for all Londoners look like?”. Our expert panellist will include Dr Raj Patel, Deputy National Medical Director for Primary Care for NHS England and NHS Improvement and Dr Victoria Tzortziou-Brown, Co-Honorary Secretary of the Royal College of GPs, as well as patient representatives and experts in migrant and homeless health.


Dr Tom Coffey OBE, Mayor of London Health Advisor, said: “The difficulties the most disadvantaged Londoners face when registering for a GP expose the stark health inequalities across our capital. Everyone should have easy access to a GP, yet this again shows that the health of Londoners is being profoundly shaped by who you are and where you live. The Mayor is taking bold steps to make London a healthier, fairer city, and we need the Government and everyone across the health and care service to do all they can to tackle these health inequalities in the long term.”

Lucy Jones, Director of Programmes at Doctors of the World UK, said: “The NHS was funded on principles of equality and non-discrimination and its better for everyone that the most vulnerable in our communities can see a GP. Yet unnecessary immigration and paperwork in GP surgeries are stopping people from getting the healthcare they need.  One fifth of our attempts to register patients with GPs are wrongfully refused. This is already worrying. However, we know that when vulnerable patients approach GP practices themselves, a successful registration is even less likely. So it’s great to see that practices and leaders in the sector are working to make their services more accessible for all”.




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