Three-quarters of general practices surveyed in London asked to see documentation before they would register patients, according to a recent survey.

Authors of the study published in the British Journal of General Practice said that such a requirement disproportionately affects marginalised populations such as the homeless, travellers and recent arrivals in the UK, who may have trouble providing such documentation.

The most common obstacle to registration with a GP practice in the UK is difficulty presenting proof of address. However, NHS guidelines stipulate that inability to provide ID or proof of address is not reasonable grounds to refuse registration. Practices may ask patients to present ID/proof of address, but need a policy in case patients cannot.

In the survey of 100 practices, Dr Nathan Hodson and colleagues at Brighton and Sussex Medical School (BSMS) discovered this was often not the case. They found evidence that websites frequently stated that documentation would be involved in the registration process, as well as conflating administrative tasks with treatment – asserting that urgent treatment is documented-dependent and misinterpreting regulations on immigration status.

Dr Elizabeth Ford, Senior Lecturer in Primary Care Research at BSMS, said: “Restricting access to GP services to those with a full set of documentation places a strain on local hospital emergency departments, which costs the NHS more money. It also entrenches inequalities in society, where people who are the most vulnerable and least well off will continue to have the worst health outcomes. Not only that, but it breaches NHS Standard Operating Principles and, possibly, the Equalities Act 2010.” 

In 12% of practices, however, the researchers found GP websites which clearly included a plan for those who could not provide documentation to get registered and to receive treatment.

They suggest that one solution would be for all GP practices’ webpages to display an approved statement about rights to access, taken from NHS guidelines, and trialled for language and acceptability with members of the public.