Everyone is welcome in General Practice

This is absolutely true. Sadly, we know that many people, including those who are most vulnerable or suffering, can feel excluded from accessing care.

People who experience homelessness and those in other inclusion health populations[1] experience some of the worst health inequalities; the average age of death for women is 42 and men 44 for people who experience homelessness.

While we know the reasons for this are many and largely lie outside the remit of the NHS, we know too that it is these same groups who are the least likely to be registered with a GP.

This is far from ideal in normal times, but right now it could also significantly reduce the likelihood of them having the opportunity to receive a COVID-19 vaccination.

Registering with a GP and getting access to the holistic and person-centered care offered in General Practice is often a life changing experience for many.

Unfortunately, the misconception remains for many that you need photographic ID, such as a bus pass, driving licence or passport, and/or proof of address, as a prerequisite for registration.

This is why, supported by the RCGP and GPC, as well as many inclusion health charities and groups, this week we launched our GP ‘Access Cards’ registration campaign.

Working with the groups who know these communities the best, we’re encouraging people to register, and reiterating this is possible even without ID documentation. These messages are encapsulated on bright yellow ‘access cards’ and accompanying campaign materials which will be distributed locally – you can view and download these on the FutureNHS platform.

We’re also suggesting four actions that General Practice can take to support this campaign and to register people who would benefit from your care:

  1. Reach out to your local authority and voluntary sector to work together on this campaign – they often know these people and can support them to access your care;
  2. Support your receptionists to complete this bitesize training on the Pathway website – Homelessness Training for GP Receptionists – receptionists are the first experience someone has in your practice and this training will support them to know what they can do to make a difference;
  3. Review your websites to include a statement that you can register without ID or address. Some websites state that you must have these – it is worth checking yours;
  4. Offer an initial health assessment for new registrants to identify vulnerability to COVID-19 and code as Clinically Extremely Vulnerable as appropriate. If the individuals are homeless, use the housing status codes. Use the Romani code if someone states that they are of Gypsy heritage.

We’re also recommending practices join the Safe Surgeries initiative run by Doctors of the World. This reassures people that immigration status will not be checked, and they are in a safe space.

Registration could help to change someone’s life. Thank you for your support for this important campaign.

[1] Inclusion health is a term used to refer to populations who experience the cliff edge of health inequalities including people who experience homelessness, Gypsy, Roma and Traveller people, Asylum Seekers and Refugees, Sex Workers, People in contact with the Justice system.

Dr Kiren Collison

Dr Kiren Collison is a GP and Deputy Medical Director for Primary Care, NHS England.
Kiren has a focus on strengthening primary care, the interface between primary and secondary care and patient safety. She has previously worked across settings, both as provider and commissioner, and has been the chair of the NHS national long COVID taskforce.