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CONFIDENTIAL TO LMC MEMBER PRACTICES ONLY, NOT TO BE SHARED OR FORWARDED IN WHOLE OR PART WITHOUT THE LMC’S CONSENT

Further to earlier advice no satisfactory assurance has been received from the NHS England Area Team that safe and adequate arrangements are in place for the provision of primary medical services to out of area registered patients in Birmingham should they be unable to access care at their registered practice.Similarly the information provided nationally by NHS England does not suggest that safe care at home can be guaranteed for any patients which you choose to register who are resident elsewhere in the country.

The advice of the LMC therefore is that, for clinical and professional reasons, practices should not register out of area patients under the new arrangements- (ie without an obligation to visit them should a home visit be clinically necessary) even though the regulations do permit such a registration.Practices should explain to any patients requesting such a registration exactly why it cannot be accommodated- ie that there is no guarantee that safe arrangements for their GP care if unable to attend the practice will be in place.

Furthermore, all practices should be aware that, unless they have signed up to the enhanced service to provide consultations/home visits to out of area registered patients, they have no contractual obligation to provide immediately necessary treatment to any such patients resident in their practice area. The requirement to provide immediately necessary treatment is limited to patients whom the practice has a) declined to register as a permanent patient and is not registered with any other practice or b) has refused registration as a temporary resident or c) is present in the practice area for less than 24 hours.

As none of these criteria can apply to patients registered under the new out of area arrangements whilst at home then the requirement to provide immediately necessary treatment does not apply (although of course the existing general requirement in respect of providing treatment, if requested, only for an accident or emergency in the practice area continues).

Should a practice be contacted to provide immediately necessary treatment by an out of area registered patient then the patient should be advised, in the first instance, to contact the Area Team in order to be advised on how to access the required care.Outside of Area Team office hours, unfortunately, you may have no alternative but to inform the patient to contact NHS 111.

Click here to download the document "Out of Area Registration".

Dr. Robert Morley
Executive Secretary
Birmingham Local Medical Committee

36 Harborne Road, Edgbaston, Birmingham B15 3AF

Tel. 0121-454 5008, Fax. 0121-455 0758
Office email: lmcadmin@blmc.co.uk
Website: www.blmc.co.uk
Birmingham Local Medical Committee
Supporting the Business of General Practice

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