Are GP practice boundaries good or bad? My email to the King’s Fund

I am a GP in Tower Hamlets. I have a particular concern about the proposal to abolish GP practice boundaries and allow patients to register with the practice of their choice, anywhere in England. When my wife and I were interviewed in 1991 to take over a practice that had become vacant, we were asked what we were going to do about the ‘outliers’ on the list. At that time it was regarded as bad practice to have people living at a distance from the practice, and good practice to have a practice population which was close to the practice. In 20 years of practice, in a myriad of ways and on a daily basis, I have seen the difficulties that occur when patients move away and continue to use us as their GPs. Managing people’s healthcare when they live at a distance is more difficult for the practice, more difficult for the patient, and leads to situations that are sometimes unsafe. I am bewildered when I hear politicians and DH people say that practice boundaries are ‘outmoded’, ‘old fashioned’, ‘anachronistic’.

In his closing remarks after a speech by Andy Burnham at the King’s Fund on 17 September 2009, your then CEO said this:

On the plan to make it easier for patients to choose their GP, Niall Dickson said: ‘The vast majority of patients are more than happy with their GP, but the restriction on where they can register is an anachronism and the government is right to sweep it away. There are details to be worked out, but it should not be impossible.’

As you will be aware, this proposal is part of the Health and Social Care Bill.

The King’s Fund says that it ‘seeks to understand how the health system in England can be improved.’ Can you tell me what the King’s Fund thinks at present on this issue of GP practice boundaries (or practice areas as they are also called)? Would abolishing them improve the health system in England? If yes, then explain how.

See Andy Burnham Speech

See King’s Fund Response to Speech

Guardian report of the event

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