Safe Surgeries network launch as research shows wrongful GP refusals

New research published by Doctors of the World UK today has found that 1 in 5 attempts to register vulnerable patients are being wrongfully refused by GP surgeries in England, despite being fully entitled to access NHS primary care.

Pregnant women, children, homeless people, survivors of torture and trafficking and people who have fled war, most of them Londoners, are among those who have been wrongly turned away. Findings demonstrate worrying inequalities in access to primary care, putting public health and the health and wellbeing of vulnerable people at risk.

Key findings of the Registration Refused study include:

• Of the 1,717 attempts* by DOTW caseworkers to register patients with their local GP in 2017, one fifth were refused.
• Lack of ID or proof of address was the most common reason for refusal (affecting 60% of attempts) and 10% of attempts were refused based on the patient’s immigration status.
• Inconsistency in decision-making indicates patchy understanding of healthcare entitlement: 14% of practices accepted some registrations and refused others, while 16% always refused.

DOTW data across 2016-2017 show similar rates and reasons for refusal over time. This indicates little progress is being made, despite NHS England guidelines which clarify that registration should never be refused due to immigration status or lack of paperwork.

“People are too often turned away by GP practices because of a lack of understanding among reception staff of their entitlements and the paperwork needed to register,” said Dr Peter Gough, GP and DOTW UK clinic volunteer.

“At the Doctors of the World clinic, we regularly see pregnant women, people suffering from mental health issues, chronic diseases and even cancer who haven’t been able to see a doctor. We need to do better to ensure that everyone can access basic healthcare, especially people in vulnerable circumstances who are often most in need.”

Launch of the Safe Surgeries initiative

In recognition of the increasing workloads faced by GP practice staff and the widespread barriers to registration, DOTW UK is today launching the Safe Surgeries initiative to support GP practices to provide safe and accessible services to everyone in their community.

Practices who become Safe Surgeries can gain access to training, tailored safe_surgeries_toolkit_A4_web_FINAL, and a supportive national network of practices committed to tackling the barriers preventing vulnerable people from accessing their services.

The first Safe Surgeries have already signed up in London, Manchester and Birmingham.

Dr Jenny Akhurst, a GP at one of our first Safe Surgeries, explained what led her south London practice to join:

“As a GP I’m concerned about the patients we’re not seeing, who are invisible to us because they haven’t been able to register or advocate for themselves.”

“We joined Safe Surgeries because we want to be clear to our staff, patients and community that we’re doing everything we can to reduce those barriers. We’ve committed to Safe Surgeries so that there is no ambiguity when people come to us: they’re entitled to register with a GP and they can do so without ID or proof of address if they need to.”

*Attempts which were refused because the patient was outside the practice catchment area or the practice list was full were excluded from the analysis.

For more information please contact Jennie Corbett: JCorbett@doctorsoftheworld.org.uk