No Scope For 'Gentlemen's Agreements' With Existing Rules, UK

Main Category: Primary Care / General Practice
Article Date: 06 Jul 2008 - 3:00 PDT

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MPS responds to Health Minister Ben Bradshaw's suggestion that some GP practices have made agreements with other GP practices not to take on each other's patients.

MPS regularly advises GPs on the rules and regulations surrounding the acceptance and removal of patients to their practice lists.

Dr Stephanie Bown, Director of Policy and Communications, said: "There are stringent regulations in place that ensure that doctors act fairly and in the interests of their patients when deciding who they will and will not accept on to their practice list.

"GPs do not remove patients from their lists lightly. They must have reasonable grounds and must give specific reasons for their decision. There is also a burden on practices to explain the reasons for their decision to their PCT, and, except in exceptional circumstances, to the patient.

"All practices have a patient list which may be open, or closed, to new patients. A practice with an open list must accept any new patient who applies unless they have reasonable grounds for refusal."

These grounds cannot include gender, race, religion or sexual orientation; nor can they relate to a patient's medical condition. The refusal of an application from a patient who lives outside the geographic area of the practice would be considered reasonable. All practices must maintain a written record of refusals and this must be made available to the PCT.

A PCT will only close a practice list to new patients if it is satisfied that the quality of care the practice can provide to patients could be compromised if further patients were registered with the practice. A practice cannot take the decision to close its list unilaterally. It must follow a formal application process to the PCT - the decision is taken by the PCT and is subject to regular review.

Medical Protection Agency