Plans to scrap GP practice boundaries draw fire

A BMA paper - Reforming General Practice Boundaries - warns the policy of allowing patients to be on the list of any practice they choose would have unintended consequences for continuity of care and funding for practices.

Instead of doing away with practice boundaries, the BMA’s GPs committee has called for more incremental change

The NHS Alliance published the results of a survey of primary care managers and clinicians in which more than two thirds of respondents said GP boundaries should not be scrapped.

Health secretary Andy Burnham announced the policy, which the Conservatives have also laid claim to, in his first major speech as health secretary in September.

A consultation on the policy is expected soon, prompting the action this month from the BMA and the alliance.

The BMA paper warns that to introduce the policy systems would be needed to protect and track “at risk” patients, funding arrangements for GP practices would need to be reformed to ensure that funding for all practices is fair and equitable, and popular practices that had reached the limit of physical capacity would need to be helped to improve their premises.

Instead of doing away with practice boundaries, the BMA’s GPs committee has called for more incremental change.

It is backing the use of webcam consultations, a change to “temporary resident” arrangements that would allow patients to be treated by a distant practice ad hoc, and “fuzzy boundaries” to GP catchments.

This would allow some, but not all, patients to register with a practitioner situated further away from their home.

GPs committee deputy chair Richard Vautrey said: “We think there are opportunities in the current system to achieve what the government is trying to achieve - greater choice and flexibility for patients.

Alliance chair Michael Dixon said he “yet to be convinced” that insufficient choice in general practice was a universal problem.

“Some people say this policy has come about because some policy advisers have to get early to Westminster and can’t access doctors,” Dr Dixon - a practising GP - told HSJ.