The Department of Health’s ‘reply’ to my email to Jeremy Hunt

In mid-February 2015 I emailed Jeremy Hunt raising concerns about the policy allowing patients to be registered with participating GP practices even though they live outside the practice area. The policy was implemented on 5/1/15. It is a deeply flawed policy which sounds good on paper (unless you understand how general practice works), but when transferred into the real world is a mess. (It is as though someone asked an architect to actually build a building according to an Escher lithograph).

Just one of the problems in the real world is to provide cover for patients who get sick at home and cannot travel to see their registered GP. (A patient registered with a local GP would walk to their GP or, if unable to leave their home, be visited by their GP). So NHS England area teams were given the Herculean task of organising this cover. The October 2014 launch of the policy was put forward to 5/1/15 because they had not yet put in place the infrastructure for this cover. What I discovered in January 2015 was that there was still not blanket cover across England; in fact in London there was effectively no cover. So the situation was unsafe for London patients registering with a practice at a distance from their home.

This is the reply I received from the Department of Health:

Our ref: DE00000920945

Dear Dr Farrelly,

Thank you for your correspondence of 15 February to Jeremy Hunt and Norman Lamb about GP practice boundaries. I have been asked to reply.

As you are aware, the GP contract agreement for 2014/15 brought in a measure allowing GP practices to register new patients from outside their traditional boundary areas without a duty to provide home visits for such patients, as they previously had to do.

With this change, provisions such as home visits need to be in place for patients should they need urgent care at or close to home and cannot attend the practice they are registered with. NHS England is responsible for making sure this happens. Its area teams are currently working with GPs and the NHS 111 service to make sure these services can be provided.

As you are aware, it was originally planned that the measure would come into effect from October. However, in order to allow its area teams more time to put services in place, NHS England took the decision to put the date back to 5 January. It believes that this decision was in the best interests of GP practices and patients.

I note that you have written to NHS England directly about your concerns. I hope that you receive a response soon.

Whilst I appreciate that this may be a disappointing reply, I hope it clarifies the situation.

Yours sincerely,

[I have removed the name to protect the innocent]
Ministerial Correspondence and Public Enquiries
Department of Health


Attentive readers will notice that this is a non-reply. This is typical of replies I have had from the Department of Health: a bland, entirely unnecessary, description of the protocol but ignoring entirely the issue of patient safety and the proper working of this policy.

I did in fact email NHS England (they were copied into my email to Jeremy Hunt as well), but I have not received a reply.

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