Greenwich GP Access report 2017

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Summary of report content

According to the findings of a research by the Royal Borough of Greenwich, an estimated 1.2 - 5.4% of the Greenwich population were not registered with a GP. One concern was that even though it did not comply with NHS England guidance, the GP practices were requesting, in some cases, passports/photo ID as well as 2 proofs of address when registering, which some homeless and immigrant status patients were unable to provide. Some practices were also identifying and de-registering ‘ghost’ patients (those not used the GP for 5 years or more) in the effort to cleanse their list. As a result, this was limiting the amount of people that could attend the GP Access Hubs which replaced walk in centres. This in turn was placing pressure on the Accident and Emergency and Urgent Care Centre, as that is where they would eventually go. Besides the GCCG’s effort, in 2015, to spread awareness through a GP registration campaign which produced a leaflet saying “immigration status does not affect your right to register with a GP, in fact you shouldn’t even be asked” after concerns some black and minority ethnic (BME) residents were reluctant to register because of their immigration status, HW Greenwich conducted an audit between January and March 2017, in which HW staff and volunteers phoned all 48 GP practices to find out about the information needed for registering. HW also carried out an audit of the GP websites to identify any advice and guidance provided about registering with them. They found that apart from Vanbrugh Group Practice, all other practices requested some form of registration documentation, ranging from passport identification to two forms of proof of address. 46% of practices requested proof of identity. 26% practices requested two proofs of address. 24% practices requested one proof of address. Although most practices had a link on their website to download the registration form, none of them had any information about patient’s rights to registering without documents, or immigration status not being required. Although no practices requested immigration status documents to register, 32 of the practices did request passports or photo ID. Despite no evidence that administrative staff were making decisions to register on their legal status, this requirement could act as a significant deterrent to many people. HW reports that 58% of the GPs administrative staff were either unsure or asked to refer to the practice manager to confirm when a person can at all register without documentation. 31% of the practices stated they could register patients without any proof of address or form of identification, only after referring to the practice manager. One practice positively stated to this question that they “can and must register...and would never turn anyone away”. Overall, the report findings indicate that despite these efforts, many Greenwich GP practices are still not adhering to the patient registration guidance provided by the NHS, CQC and other professional bodies. Based on the findings, several recommendations were proposed, and the service providers responded individually some finding the report ‘informative’ whiles others explaining their policies.

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General details

Report title 
Greenwich GP Access report 2017
Local Healthwatch 
Healthwatch Greenwich
Date of publication 
Friday, 25 August, 2017
Date evidence capture began 
Wednesday, 4 January, 2017
Date evidence capture finished 
Thursday, 23 March, 2017
Type of report 
Key themes 
Information providing
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
Structured interview
Unstructured Interview
How was the information collected? 

Details of health and care services included in the report

Primary care services 
GP practice

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Types of health and care professionals engaged 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Implied Impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.