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DH abolishes “open but full” practice lists

Government sets out guidance on changes to rules on practice boundaries and lists

Louise Prime

Thursday, 26 January 2012

“Open but full” lists will be eradicated under the latest guidance from by the Department of Health, and PCT clusters must act by April to ensure that patients registered with a GP outside their home area can receive the same level of care that they would have received locally.

The Department’s guidance document Choice of GP practice – Guidance for PCTs insists that patients must be able to see clearly whether or not a practice is accepting new registrations, so their lists must be either ‘open’ or ‘closed’ – ‘open but full’ is too confusing for patients, the DH says.

The guidance sets out which arrangements must be put in place to allow patients a wider choice on selecting GP practices. Under it, patients who move home but remain within an outer boundary area – agreed between the practice and the PCT cluster – will be allowed to stay registered with their practice, which will continue to provide home visits.

But the Government recognises that choice must be balanced with practicality. The guidance says: “Where a GP practice already has a reasonably large boundary area, it may not be appropriate to establish an additional outer boundary area, although it is expected that this will be the exception rather than the norm.

“PCT clusters should work with GP practices to ensure that the arrangements are as fair and equitable as possible and that they serve patients’ interests.”

The DH said the three sites for the pilot programme on GP choice, chosen because they are areas with high levels of patient influx from day to day, are Central London: Westminster, City & Hackney and Tower Hamlets; Manchester and Salford; and Nottingham City.

GP practices in these areas will be able to join the pilots, which run for a year from April, on a voluntary basis. Patients who live outside the area will be able to either:

  • have a consultation at a participating GP practice as a non-registered ‘day’ patient (and remain registered with their existing GP practice)
  • or register with a participating GP practice as an out-of-area patient (and cease to be registered with their current GP practice). The GP will not be obliged to provide home visits in this situation.

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