CCGs considered refusing temporary patients

The CCGs for Crawley, Horsham and Mid Sussex, and East Surrey considered the suspension as part of a series of “difficult choices” needed to save money. Since HSJ started making enquiries, the CCGs have said the proposal is not being pursued any further at this time.

However, other options are still being explored. These include temporary suspension of IVF and other fertility funding, vasectomy and sterilisation procedures, and temporary suspension or higher thresholds for hearing aids.

Temporary resident applications are often from people working in an area for a short time or students returning from university for the holidays. While there is no separate payment to GPs for registering temporary patients and providing treatment, the costs of any further diagnostic tests and treatment in secondary care are borne by the CCG where they are temporarily registered, potentially disadvantaging CCGs with a lot of temporary residents.

Richard Vautrey, BMA GP committee chair, warned refusing to accept temporary residents could lead to more demand on A&E departments. “This would be a breach of regulations, as practices have a contractual obligation, as well as a professional responsibility, to see temporary residents in their practice area,” he said.

“GPs and their teams would rightfully be concerned that, by turning these patients away, that their health may deteriorate, forcing them to eventually seek emergency care. Pressures in the NHS are not resolved by turning patients away from general practice, but by investing and supporting in general practice and the wider NHS.”

The three CCGs are part of the Central Sussex and East Surrey Commissioning Alliance, which is planning £48.6m of savings this year. The difficult choices were part of a series of measures intended to mitigate the risk that around a quarter of these savings would not be delivered. 

In a statement, the alliance said the proposal to reject temporary patient registrations had been dropped, and added: “Our financial recovery plan, developed with our clinicians and agreed by NHS England and our governing bodies, identifies areas where we are able to make savings to ensure we are making best use of the resources available to us.

“So far this year, we have successfully delivered the plan and we are now at the early stages of assessing any further potential savings we may need to make to ensure we can meet our financial commitment.

“We are looking at all areas thoroughly, with clinical insight and scrutiny, to ensure any changes do not have a negative long term impact on the quality of patient care. However, no decisions have been made and, before they can be, we will complete a thorough assessment to help us understand how our decisions may affect people, followed by a period of engagement with local patients, carers and the public.”

The CCGs would not comment on the potential breach of regulations or the amount these changes could have saved.