The following guidance aims to clarify the conditions surrounding patient registration in GP practices. The advice applies to GP primary care services in England only.
Read our FAQs for further advice
Key point to remember
The overriding principle that applies to patient registration is anyone, regardless of nationality and residential status may register and consult with a GP without charge.
What are the contract and regulatory conditions?
Full terms and conditions of patient registration are covered in the following:
- Part 13 of the NHS England GMS Contract 2015/16
- Schedule 6, Part 2 of The National Health Service (General Medical Services Contracts) Regulations 2004
Duty to provide emergency and immediately necessary 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 that has been:
- refused application for inclusion in the contractor's list of patients
- who is not registered with another provider of essential services
- whose application for acceptance as a temporary resident has been rejected
There is no definition of immediately necessary treatment in primary medical services contract regulations.
However, in relation to people who are visiting or not a resident in England, it should be viewed as including treatment of new conditions and also pre-existing conditions that have become exacerbated during the period of a person's stay in England, subject to the contractor's clinical judgement.
Declining a patient registration
When a person does not require emergency or immediately necessary treatment, practices have only a limited degree of discretion under the contract and regulations about whether to register the person.
Practices may only decline to register a patient (whether as a temporary resident or permanent patient) if they have reasonable grounds to do so. These grounds must not be not related to an applicant's race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.
Registering without proof of identity and address
There is no contractual duty to seek evidence of identity or immigration status or proof of address. Therefore practices should not refuse registration on the grounds that a patient is unable to produce such evidence.
Anyone who is in England is entitled to receive NHS primary medical services at a GP practice and applications for registration for any patient in England must be considered in exactly the same way, regardless of country of residence.
Registering temporary or permanent residents
The length of time that a patient is intending to reside in an area will determine whether a patient is registered as a temporary or permanent patient.
Patients should be registered as a temporary resident if they are intending to reside in the practice area for more than 24 hours but less than 3 months.
Registering 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 obligation on practices regarding identity and proof of address apply to homeless patients as a population group. 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 may also use the practice address to register them.
CQC expects practices to register people who are homeless, people with no fixed abode, or those legitimately unable to provide documentation living within their catchment area who wish to register with them.
Read CQC guidance on looking after homeless patients