One GP's Protest

[Names have been redacted to protect the innocent]

From: Farrelly George (NHS TOWER HAMLETS CCG)
Sent: 09 January 2015 18:26
To: ***** (NHS ENGLAND)
Cc: Farrelly George (NHS TOWER HAMLETS CCG)
Subject: out of area patient registration

Dear ****,

I am a GP in Tower Hamlets. At present, on the NHS Choices website, there appears to be no clear guidance as to which practices are actually opting into this service. Unless I am missing something, patients have no way of knowing which practices are offering this without ringing practices one by one.

We are not offering this because we do not feel it is workable, but if patients approach us we would like to have something to offer them in the way of signposting participating practices.

Best wishes,

George

The Tredegar Practice
35 St Stephens Road
London E3 5JD

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From: ****** (NHS ENGLAND)
Sent: 15 January 2015 09:33
To: Farrelly George (NHS TOWER HAMLETS CCG)
Cc: ****** (NHS ENGLAND); ***** (NHS ENGLAND)
Subject: FW: out of area patient registration

Dear George

Thank you for your e-mail and please accept my apologies for the delay in responding to your query.

We currently don’t hold a central list of those practices that have expressed an interest in delivering out of area registration for patients, however, area teams have been provided with information via the e-declaration of those practices that indicated an early interest in the scheme so you may wish to contact NHS London who should be able to provide you with further information of local practices who may register patients out of area.

If I can provide any further assistance please do not hesitate to contact me or one of my colleagues.

Best wishes

******

******
******NHS England | 4E60| Quarry House | Leeds | LS2 7UE

High quality care for all, now and for future generations

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Email George Farrelly to NHS England, London; 23/1/15; 08:22

Dear NHS England London (North East Area Team),

I sent the following email (see above) to NHS England and you can see from this email thread that they have suggested, for the situation in London, that I contact you. I have a number of reasons for wanting to know how patients are to find practices that are signed up to registering patients who do not live locally (one is to direct patients who enquire).

“I am a GP in Tower Hamlets. At present, on the NHS Choices website there appears to be no clear guidance as to which practices are actually opting into this service. Unless I am missing something, patients have no way of knowing which practices are offering this without ringing practices one by one.

We are not offering this because we do not feel it is workable, but if patients approach us we would like to have something to offer them in the way of signposting participating practices.”

Do you have a list of London practices (or north east London practices) who have expressed an interest or have signed up to registering patients who live out of area?

You can reply to this email, or if you prefer my mobile is ***** *** ***.

Best wishes,

George

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Email George Farrelly to NHS England, London; 23/1/15; 09:08

Dear NHS England London,

I now have an additional question which relates to the other side of the coin: that is, patients who are resident in Tower Hamlets but have registered with a practice in, say, Ealing near where they work.

If that patient gets ill and is stuck at home on Tower Hamlets, the new arrangement is that they access a Tower Hamlets GP who is providing an enhanced service to these sorts of patients. But who is providing this in Tower Hamlets? (A recent Pulse article has suggested that the Out of Hours service might be called upon to provide this service, but that would mean they would have to be operating In Hours as well….). I will be speaking to our out of hours service shortly….[I spoke to the Tower Hamlets out of hours service; they had not been approach to provide in hours cover]

My understanding is that NHS 111 would have that information.

I have just rung NHS 111 covering Tower Hamlets but the helpful nurse advisor I spoke to was unaware of the new policy; she could only suggest that a Tower Hamlets resident without a local GP would have to go to a walk in centre or to A+E. She spoke to her supervisor who was also unaware of the new policy and where such a patient might be directed.

Can you help? (Can I say I sympathise with your situation: you did not dream up this policy but you have been given the task of implementing it….).

Again, my contact number is ***** *** ***.

Best wishes,

George

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15/2/15: I have not had a response from NHS England London.

I have since contacted NHS 111 for Islington where I live and they also did not know about the policy and they gave the same answer as NHS 111 for Tower Hamlets. I then rang NHS 111 for central London (this includes Chelsea and Westminster, Camden, Hammersmith, and others); they too are were unaware of the new policy and did not have a list of local GPs who could offer In Hours care for patients not registered locally.

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12/6/15 update: I still have not had a reply from NHS England. I emailed Jeremy Hunt about this problem as well. The Department of Health gave a characteristically evasive and meaningless reply, but noted that I had written to NHS England.

A few days ago, I checked again with NHS 111 for Central London. The supervisor did not have an accurate understanding of the GP Choice Policy, and said there was no infrastructure in place to provide primary care services to local residents not registered with a local GP. They were not in a position to arrange visits to those requiring them, or consultations with local GPs. They would be advised to go to a Walk In Centre or to A+E.