Practices should know the rules regarding temporary residents, homeless patients, overseas visitors, the duty to give treatment, and when they can decline to register a patient.
Practices have a contractual duty to provide emergency treatment and immediate necessary treatment free of charge for 14 days.
Practices have limited ability under the contract as to whether to register a patient or not.
Patients registration information and the ability to register should be available throughout core opening hours. Registration methods include paper, digital and in person, and accessible to all patient groups and needs.
There is no regulatory requirement for a patient to prove identity, address, immigration status or provide an NHS number to register. However, there are practical reasons why a practice needs to be assured that people are who they say they are, or to check where they live. Seeing some form of documentation regarding the patients identity can help to ensure the correct matching of a patient to the NHS central patient registry, thereby ensuring any previous medical notes are passed to the new practice. It is legitimate therefore for the practice to apply a consistent but non-discriminatory approach when requesting patient ID as part of the registration process.
A patient does not need to “Ordinarily Resident” in the country to be eligible for NHS primary medical care.
The practice will need to determine if the patient is registered as a temporary or permanent patient based on individual circumstances.
Patient registration will also be based on whether the patient resides within the practice boundary which it covers. If a patient is registered as an out of area patient as they reside outside the practice boundary the practice is not obligated to provide home visits or services out of hours, this will be decided by the individual practice on a case-by-case basis.
If a patient is refused registration, then they must record the name, date, and reason they have been refused and write to inform them of the refusal within 14 days.
Further guidance is available at BMA patent registrations and BMA – Out of area registrations and patient choice.
For further information: Primary Medical Care Policy & Guidance Manual (PGM)(V5), page 42-50, 4.1- 4.18.2
If you receive a request from PCSE for list validation you do need to comply.
This falls within the GMS contact as a reasonable written request from the board to:-
(b) provide information relating to its list of patients as soon as is reasonably practicable and, in any event, no later than 30 days from the date on which the request was received by the contractor, in order to assist the Board in the exercise of its duties under paragraph (1), contacting patients where reasonably necessary to confirm that their patient data is correct.
The GPC’s view is that sending this from an NHS.net email to an NHS.net email is a secure way of transferring this information.
List maintenance / reconciliation processes are something that PCSE has always done. Depending on the area and issues this is either done by looking at specific groups of patients, or by doing a list reconciliation exercise on practices in turn, which can be every 3 years or so.
By taking a extract from your clinical system they can then confirm that it matches the record at their end so that your weighted list size is based on the correct patients.
We would recommend trying to clear the patients stuck in the link as much as possible before you do the extract (new registrations and deductions processed etc) so that it is as up to date as possible, but bear in mind that it needs to be responded to within the 30 days.
You may find that some patients end up with FP69’s as part of the process but that will depend a bit on the accuracy of your list currently.
PCSE will send instructions on how to extract the data.
PSCE are contracted to run data quality checks on specific cohorts of patients to ensure patients are reigstered correctly.
The cohorts are:
- Patients over 100 years of age (where they haven't changed address or had a PDS check in the last 12 months)
- Patients who registered with the NHS for the first time 12 months ago having previously resided abroad (immigrants)
- Patients who live in addresses with 8 or more registered residents
- Patients who have been a student for 4 or more years
- Patients who are resident at an address recorded as demolished by the Royal Mail.
The list maintenance is done in a number of ways - either by contacting the practice, sending letters to the patient or emailing the patient.
Where PCSE contact the practice it is advised to respond asap. A lack of respnose may result in an FP69 being set.
Practices are required to submit temporary resident forms to PCSE so that they can be sent onto the patients registered practice. The GMS3 form should include their details and notes concerning thier illness / presentation completed by the clinician who saw them.
There are two ways to submit the forms.
Upload the scanned form and accompanying information via PCSE online.
Arrange a collection by requesting a transit label from PCSE online.
The patients registered practice will then either download the GMS3 from PCSE online or receive a hard copy to ad to their medication record.