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BMA 'skewed list' warning over boundaries

BMA 'skewed list' warning over boundaries

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The abolition of practice boundaries could destabilise general practices in local areas, claims a British Medical Association (BMA) representative.

The government's White Paper, Equity & excellence: Liberating the NHS, has committed that by April 2012, every patient will have a clear right to choose to register with any GP practice with an open list and without being restricted by where they live.

Seventy-five percent of patients who responded to a government consultation last year backed the policy and said they wanted greater ability to register with a practice of their choice.

Dr Richard Vautrey, deputy chair of the British Medical Association's (BMA) GPs committee, argues the majority of such respondents require the flexibility to choose a general practice in their local area.

This would be "within a few miles of where they live and not, as the government suggests, where they work - which could be 50 to 100 miles away from their home," said Dr Vautrey.

While he claims the government is listening to GPs concerns over the controversial policy, he told Management in Practice he is forced to continually warn the government of the many risks involved.

"If large numbers of commuters are coerced into registering at a GP near their workplace, this could potentially have huge implications for the practices they leave behind," said Vautrey.

"If you end up with skewed lists, this will result in destabilising general practices in local areas."

The policy may seem superficially attractive to patients, argues Dr Vautrey, but the long-term consequences could mean higher costs to the NHS. For example, he says patients may turn to A&E departments instead of GPs when they fall ill because their GP is too far away from their home.

"The vast majority of patients told us that they want to be able to register with a GP practice of their choice in our consultation on practice boundaries," said a spokesperson for the Department of Health.

"We aim to give patients far greater choice of GP practice from April 2012."

The spokesperson went on to tell MiP that the government is currently discussing its proposals with GP representatives.

"Any changes that might need to be made to the General Medical Services contract will be negotiated in the usual way between the BMA's GPs committee and NGS Employers on behalf of the Department of Health," said the spokesperson.

The BMA has proposed 'safer' alternatives to the widespread abolition of practice boundaries. These include: the widening of temporary resident arrangements and an increase in the flexibility of practice boundaries.

Dr Vautrey is hopeful that a compromise can be reached. "We hope that our proposals will be taken onboard and we hope common sense will prevail," he said.

"Those officials within the government that understand the knock on consequences of pursuing this policy are very supportive of our position and believe in the need to be cautious."

Your comments (terms and conditions apply):

"As a semi-rural practice, the majority of our working patients travel to areas some distance away.  If they were to register where they work our list size will reduce and capitation reductions will result in loss of staff and doctors.  This would mean difficulties in responding to "temporary residents" who might want GP services near home.  We already suffer with a large number of university students etc coming home for
summer calling on us for med requests etc." - Graham Daniel, Doncaster

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