This guidance will clarify the conditions surrounding patient registration in GP practices in England.
The main principle is that anyone, regardless of nationality and residential status, may register and consult with a GP without charge.
Contract and regulatory conditions
You can read the full regulations which this guidance is based on in:
- part 13 of the NHS England general medical services contract
- schedule 3, part 2 of the NHS general medical services contract regulations 2015.
Duty to provide emergency treatment
Practices have a contractual duty to provide emergency treatment and immediately necessary treatment free of charge for up to 14 days.
This applies to any person within their practice area:
- who has been refused application for inclusion in the practice’s list of patients
- who isn’t registered with another provider of essential services
- whose application for acceptance as a temporary resident has been rejected.
Immediately necessary treatment in relation to people who are visiting England should be viewed as treatment of new and pre-existing conditions that have got worse during their stay. This is subject to the GP’s clinical judgement.
Declining a patient registration
Registering without proof of identity or address
There is no contractual duty to seek evidence of identity, immigration status or proof of address. Practices should not refuse registration on the grounds that a patient is unable to produce such evidence.
Practice staff do not have to make any assessment of immigration status or eligibility for NHS care; they are not expected to act as immigration officials.
People who are homeless have particular health needs and often suffer some of the worst outcomes. Both the BMA and NHS England are committed to ensuring homeless patients receive the same level of care as those with permanent addresses.
The same rules as above regarding identity and proof of address applies to homeless patients. Homeless patients are entitled to register with a GP using a temporary address, which may be a friend’s address or a day centre. The practice address may also be used to register them.
Tourists and overseas visitors
Patients with no immigration status
Immigration status makes no difference, any person in the UK is able to register with a GP practice and receive NHS primary medical services free of charge. Practice staff do not have to make any assessment of immigration status or eligibility for non-primary NHS care. You are not expected to act as immigration officials.
If you believe that someone is fraudulently trying to obtain treatment you should inform NHS England or your CCG.
Patients about to be released from the secure estate
GPs have a contractual obligation to accept a patient for pre-registration prior to their release from the secure residential estate. GP practices are asked to ensure that processes are in place to support this.
Plans are also progressing to enable patients to register with a GP in their place of detention in the same way as they register with a community GP. This will be rolled out next year across England.