Patients will be able to pick a GP anywhere in the country

Patients will be able to register with any GP in an overhaul designed to help commuters to see doctors near their workplaces and allow people to switch to better surgeries.

Current rules that force people to register with GPs near their homes will be abolished within the year. Instead patients could sign up for any surgery they choose and practices that lose patients because they provide poor quality of care could face closure.

The plans will be outlined by Andy Burnham, the Health Secretary, this morning. The Conservatives signalled broad support, meaning that a radical overhaul of how GPs operate within the community is on the cards regardless of who wins next year’s election.

Mr Burnham will use a speech to the King’s Fund today to portray the NHS as “good” without being “great” and set out a series of improvements, including linking hospital budgets to patient satisfaction. He will call for a “relentless focus on a people-centred service”, with more attention on issues such as the bedside manner of doctors and nurses, the quality of food, the cleanliness of wards and the warmth of the welcome from receptionists.

Mr Burnham will say that primary care in England must be tailored to the demands of busy lives, with commuters allowed to register with GPs near workplaces and parents with practices near schools. Currently, patients must change GP if they move away from an area for longer than three months. The changes will allow them to stay with a tried and trusted GP.

“I can see no reason why patients should not be able to choose the GP practice they want,” Mr Burnham will say. “Many of us lead hectic lives and health services should be there to make things easier. A busy mum needs flexibility — she may want to register at a practice near her children’s school. A commuter may want to register near work. I want them to be able to do this whilst ensuring that home visits won’t be affected wherever someone ends up registering.”

Doctors’ leaders flagged up a range of potential problems, questions such as who would carry out home visits to commuters registered near work; how continuity of care could be guaranteed for patients who switched GPs frequently; and what would happen to patient lists in remote areas. They said that GPs with good reputations locally risked being overrun with requests but that they were happy to discuss changes with Government.

A Department of Health source said that a consultation process would address all concerns, that the reforms would be advanced robustly and that “no blank cheques would be written” to win over opposition.

The source said that measures would be introduced to ensure that good GPs were not overwhelmed. Currently, GPs have patient lists that limit the number who can register with them. Under today’s proposals doctors could still turn away patients if their lists were full. The source added that popular surgeries might consider expanding to meet demand.

Laurence Buckman, the chairman of the British Medical Association GPs’ committee, said that there was broad support for the idea but that its implementation would be “fearsomely complicated”. He said: “If you get into the detail it gets very difficult. There is this belief that competition is great but most GPs don’t want more business — they have their work cut out already.”

The measures follow several initiatives to extend access to primary care in the wake of a change to the GPs’ contract which allowed them to give up providing out-of-hours care. These include £250 million spent on more than 150 polyclinics, which were widely opposed by doctors.

Andrew Lansley, the Conservatives’ health spokesman, said that his party had always argued that greater GP access was needed, and that it would support such a reform as “a small step in the right direction”. He said: “It was ludicrous for the Government to talk about giving people a choice of GP when they restricted that choice based on their postcode. That is why we announced plans to abolish practice boundaries two years ago. It is only a small part of the much bigger package of reform that we need to make to our system of family doctors.”


source : http://www.timesonline.co.uk