Agenda item

Director of Community and Children’s Services

The Board noted the summary of the report from NHS England, Out of Area

GP Registrations from 1 October 2014: Update for City of London Health and

Wellbeing Board. The reports outlined the changes to GP contracts from October 2014, although it was noted that this date had now been moved to 5^th January 2015. As a result of these changes, GP practices who choose to would be able to accept registrations from patients who were not resident in their practice area (“out of area patients”).

The presentation from NHS England outlined the changes and the resulting challenges if this scheme was adopted locally.

NHS England area teams would be required to put in place arrangements to

secure in-hours primary medical care services for out of area patients who live

in their area. These would provide access to a home visit when clinically needed, or more likely, when an out of area patient was too unwell to be expected to travel to their registered practice area but could travel to a local provider for a consultation with a GP or other healthcare practitioner.

Discussions ensued regarding the legal challenge which GPs may face if they did not endorse the contract changes. Officers clarified that the legal aspects were still being discussed and had not yet been confirmed. Members noted that the City of London had a very high daytime population (mainly City workers) compared to a small resident population, meaning that demand from out of area patients to register with a GP in the City could be very high and it was unlikely that the single local GP practice could meet this demand in its current state. It could also be difficult to predict demand. A decision was yet to be taken about whether GP practices within the City and Hackney CCG area would opt to participate in the scheme.

It was agreed that NHS England would update the Board again to provide clarification on legal issues following the implementation of the contract changes in January. Healthwatch highlighted their role in understanding residents’ concerns regarding the changes.