Published: 08/01/2004, Volume II4, No. 5886 Page 7

Patients' 'dual registration' with more than one GP is to be piloted by personal medical services practices, guidance on making PMS contracts permanent has revealed.

The guidance, issued just before Christmas, says that more details will be produced before the end of this month. But National Association of Primary Care chair Dr Peter Smith said it was likely to involve specialist PMS practices.

The opportunity for patients to register with more than one GP was announced after last year's widespread consultation on patient choice.

The suggestion was that commuters would be able to register with a GP near their work, as well as their 'home'GP.

But Dr Smith said the pilots were more likely to involve specialist PMS practices that have to provide only a limited number of primary care services, such as treatment for drug abuse, and may not even include any doctors.

This would mean patients would have to register with another practice to ensure they could receive the full range of primary care services.

NHS Alliance spokesman on PMS Dr Ron Singer said dual registration would be 'a clinical and bureaucratic nightmare', and he criticised the flexibility included in the guidance that would allow PMS practices to receive payments for variations on the 'quality and outcomes' section of the new GMS contract that rewards GP practices for providing wider and higher-quality services.

The guidance says that PCT medical directors or directors of public health will be able to approve alternative systems for rewarding PMS doctors, and Dr Singer said this would be 'labour intensive' for PCT management.

Dr Smith said PMS GPs would be more concerned that they have been given a deadline of next Friday to agree initial arrangements with their PCT.

Guidance on implementing the GP contract was also produced in the week before Christmas. NHS Alliance chair Dr Michael Dixon said the document would at last allow PCTs to 'get on with the job' of making sure the new contract would happen successfully.