LMC article dated 21September 2012

Once for London Patient Registration principles - important information from Londonwide LMCs

Message to all Londonwide GPs and practice teams.

The Once for London principles for registration were signed off by representatives from Londonwide LMCs, NHS London and all London PCT clusters. The document was unfortunately sent to practices without Londonwide’s being informed, which precluded our being able to send practices our own covering explanatory letter.

This document does not supersede the Contract Regulations (copied below) and is not mandatory, but is an attempt to offer guidance to practices on how to avoid challenges under the contract regulations, complaints from patients or pressure groups and possible breaches of discrimination legislation. It was also intended to offer protection for practices and patients from the increasing propensity of registration departments to use practices as unofficial fraud and immigration inspectors.

 The Contract Regulations are mandatory. They make no reference to proof of identity or intention to be ordinarily resident. They do require any refusal of an application to register to be reasonable (undefined, other than including that the patient lives outside the practice area), to be followed by a letter to the applicant within 14 days and for a record of such refusals to be kept available to the PCT for inspection.

Statutory
Instruments

2004 No. 291

NATIONAL
HEALTH SERVICE, ENGLAND

The
National Health Service (General Medical Services Contracts) Regulations 2004

Other contractual terms

26.—(1) A contract must, unless it is of a type or nature to which a particular provision does not apply, contain other terms which have the same effect as those specified in Schedule 6 except paragraphs 31(6) to (8), 35(5)
to (9), 36(5) to (17), 101(5) to (14) and 102.

(2) The paragraphs specified in paragraph (1) shall have effect in relation to the matters set out in those paragraphs.

SCHEDULE
6

OTHER
CONTRACTUAL TERMS

PART
2

PATIENTS

Application for inclusion in a list of patients

15.—(1) The contractor may, if its list of patients is open, accept an application for inclusion in its list of patients made by or on behalf of any person whether or not resident in its practice area or included, at the time of that application, in the list of patients of another contractor or provider of primary medical services.

(2) The contractor may, if its list of patients is closed, only accept an application for inclusion in its list of patients from a person who is an immediate family member of a registered patient whether or not resident in its practice area or included, at the time of that application, in the list of patients of another contractor or provider of primary medical services.

(3) Subject to sub-paragraph (4), an application for inclusion in a contractor’s list of patients shall be made by delivering to the practice premises a medical card or an application signed (in either case) by the applicant or a person authorised by the applicant to sign on his behalf. Refusal of applications for inclusion in the list of patients or for acceptance as a temporary resident.

17.—(1) The contractor shall only refuse an application made under paragraph 15 or 16 if it has reasonable grounds for doing so which do not relate to the applicant’s race, gender, social class, age, religion, sexual
orientation, appearance, disability or medical condition.

(2) The reasonable grounds referred to in paragraph (1) shall, in the case of applications made under paragraph 15, include the ground that the applicant does not live in the contractor’s practice area.

(3) A contractor which refuses an application made under paragraph 15 or 16 shall, within 14 days of its decision, notify the applicant (or, in the case of a child or incapable adult, the person making the application on their behalf) in writing of the refusal and the reason for it.

(4) The contractor shall keep a written record of refusals of applications made under paragraph 15 and of the reasons for them and shall make this record available to the Primary Care Trust on request.

Last updated : 21 Sep 2012

The NHS London advice known as Register Once for London is attached and is still supported by David Sturgeon, the Primary Care Director for London. Email any queries to David.Sturgeon@nhs.net and was confirmed at Enfield Scrutiny panel on 15th October 2015

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