Patient Registration and Out of Area Policy

1. Introduction

1.1 Policy statement

This organisation will ensure there is equitable access for all patients who wish to register with the organisation.

The registration process must be followed diligently. A patient does not need to be ordinarily resident in the country to be eligible for NHS primary medical care. Therefore, anybody in England may register and consult with a GP without charge and without producing any form of identity. 

It is a contractual requirement that, once registered, all patients must be invited to participate in a new patient health check. However, neither registration nor clinical appointments should be delayed because of the unavailability of a new patient health check appointment.

1.2 Status

In accordance with the Equality Act 2010, we have considered how provisions within this policy might impact on different groups and individuals. This document and any procedures contained within it are non-contractual, which means they may be modified or withdrawn at any time. They apply to all employees and contractors working for the organisation.

2. Patient registration

2.1 Registering the patient

Patients wishing to register with this organisation can complete the online registration process, which is detailed on the organisation’s website. Should the patient complete the online registration process, a supporting signed letter from the patient, posted or emailed to the organisation, is acceptable to complete the registration (i.e., patient signature). Alternatively, patients with limited or no access to the online service may complete a PRF1 which replaced the GMS1 form. 

Additional guidance for patients is available from How to register with a GP surgery. 

2.2 Requesting documentary information from patients

This organisation cannot refuse an application to join its list on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

Additionally, there is no regulatory requirement to provide identity, address, immigration status or the provision of an NHS number to register with the organisation. However, there are practical reasons why this organisation might need to be assured that people are who they say they are, or to check where they live. Seeing some form of ID will help to ensure the correct matching of a patient to the NHS central patient registry, thereby ensuring any previous medical notes are transferred.

Should this organisation request documentation to verify a patient’s identity or immigration status, then the organisation must ensure the same process is applied to all patients requesting registration. This organisation must not expect a patient to present a photograph as this could be discriminatory. 

It must be acknowledged that while most patients will not find it difficult to produce ID, there will be some patients who live in the practice area but are legitimately unable to produce any documentation. Examples are detailed within the PGM at section 4.9.6.

2.3 Declining applications

This organisation is permitted to decline a patient’s application to join the practice if:

• The commissioner agrees that the organisation list may be closed to new patients
• There are reasonable grounds to do so, e.g., the patient has previously been removed from the organisation list

Any refusals will be confirmed in writing to the patient, with the reasons fully stated, within 14 days of the refusal. The date and reason for refusal will be recorded along with the name of the patient and this information will be made available to commissioners if requested.

2.4 Practice areas

All organisations are required to have agreed an inner boundary with their commissioner. Anyone residing within this area is entitled to apply to register for primary medical services and the organisation boundary must be clearly advertised to patients on the organisation’s information leaflet and/or website.

East Trees Health Centre boundary can be found on the website

Search: 'Register with us as a new patient' for the boundary map.

The practice reserves the right to request that patients who are currently registered outside the boundary area register with a practice nearer their address. This is to ensure continuity of care, avoid delays in treatment (lack of home visits) etc.

There has been public perception that patients are being removed from practice lists because their care is too costly, their clinical condition or their age.

Regulations specifically require that a removal is not on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.  East trees practice policy does not discriminate but ensures that patients who move within the practice boundary area can register on request as list sizes grow, when patients outside the practice boundary can register with a practice nearer their home address.

The practice administration team will ensure that a patient who lives or moves outside the boundary area, receives notification in writing in advance of a removal and that the patient is given 30 days’ notice to enable them to find a local practice. Medical records will be transferred to the new practice via GP2GP electronic transfer and any medication required by the patient will be given to avoid delays in prescribing by the new GP practice.

To be fair and equitable to all, the only exception to this policy will be for terminally ill patients who have moved into a hospice or relative’s home, as long as this is deemed within home visiting distance.

Patients who move out of area temporarily (rehabilitation) may be kept on for up to 3 months depending upon circumstances but will be advised that they will be removed once this period has ended, unless they have moved back to the original address.

Patients who move to university will be advised that they should register with the University Health Centre and if required, register as a temporary patient (up to 15 days) with East Trees Health Centres during holidays. They can re-register if they move back to their home address.

Patients who are homeless and wish to register at East Trees Health Centre will be directed to Homeless Health which is a contracted health provider aimed at this cohort of patients.