Patient registration

Practices should know the rules regarding temporary residents, homeless patients, overseas visitors, the duty to give treatment, and when they can decline to register a patient.

Location: England
Audience: GPs Practice managers
Updated: Thursday 27 January 2022
GP practice article illustration

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:


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.


Homeless patients

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.

CQC guidance on homeless patients


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.