Agenda item

Les Smith, Overview and Scrutiny Officer, explained the background to the consultation document and the options identified in the document for patients to register with a GP practice of their choice. The Committee then discussed the document.

A Member informed the Committee he had discussed the document with a semi-retired GP, who had suggested the proposals were driven by politics rather than a clinical need for change. He said the GP had not seen a need to change the current system.

Members noted that continuity of care was important. They considered that the more services were fragmented, the more difficult it would be to properly treat the individual. They believed that most people would prefer to be treated by their local GP, who knew their history. A Member said that many GP practices offer some evening and / or Saturday morning appointments to cater for those who found it difficult to see the Doctor during normal working hours.

Members discussed the suggestion, in paragraph 2.12 of the consultation document, that a patient’s record of home visits might be taken into account when considering which practice to register with. The Committee noted that a home visit might be required at any time and concluded all practices should assume that home visits would be required.

Members noted the proposal to introduce new ways of defining practice boundaries. They believed the current system worked well and saw no need to make significant changes. They were concerned at the disclosure in paragraph 3.3 of the document, that over 800 practices are believed to have closed their lists to new patients without having first agreed this with the PCT. The Committee considered this reduced the choice that patients currently have in their choice of GP practice. Members noted that the PCT already had powers to deal with such practices and believed those powers should be used.

Members noted that both options A and B had a significant weakness in that a Doctor conducting a home visit for an out of area patient would not have access to their health information until the ‘Summary Care Record’ was in place. Members believed that a Doctor should have full access to a patient’s history when treating and were concerned that a summary may cause confusion. They were also concerned that the Summary Record could be insecure and increase the risk of patient’s data being lost, particularly if accessed through portable devices.

Members concluded that, for the majority of people, the current system of registering with a local GP worked well and provided continuity of health care. They recognised that for some people, the ability to register with a practice some distance away, for example close to where they worked, would give them better access to GP services. They noted the weaknesses identified in the document relating to dual registration, but concluded that this provided the best way of meeting that need.

The Committee concluded that a response should be sent to the Department of Health confirming that dual registration should be offered for those patients who regularly spend significant periods of time away from home.

Resolved: That a letter be sent in response to the consultation document, saying there was no need to amend the current system of practice boundaries but that dual registration should be available for those people who regularly spend significant periods of time away from their home.

The web cast from this session is available at: http://clients.westminster-digital.co.uk/maidstone/Archive.aspx