The government is proposing to scrap these boundaries, allowing patients to register with any surgery they wish. In a speech about the NHS over the next decade, Health Secretary Andy Burnham said: “too often, people’s choice of GP practice is unnecessarily limited by practice boundaries”.
He said that allowing patients to register with a GP near to their work means that “their practice is based on their own needs, not by lines on a map or what is easiest for PCTs”.
The New Local Government Network (NLGN) said that the announcement would help to introduce more choice and convenience for patients and allow them to structure their health needs more effectively.
Nigel Keohane (author of a report entitled People Power: How can we Personalise Public Services?) said: “Citizens now rightly expect their public services to fit around their daily lives, in terms of convenience, time and point of access, choice of providers and speed of delivery.”
Chairman of the British Medical Association’s (BMA) GPs Committee, Dr Laurence Buckman, said he was open to discussing ways of improving choice for patients but expressed concern over some of the logistical elements of the proposal.
“Home visits with a GP a long way away would become difficult, and costly for the NHS to fund,” he said, pointing out that: “Practices in rural and suburban areas could lose significant numbers of young, healthy, patients, destabilising their funding and threatening their viability. Meanwhile, city centre practices would be inundated with requests for appointments at lunchtime and evenings, which would effectively limit patient choice.”
Dr Buckman also highlighted that all district nurses, hospital services, and social services operate within defined boundaries, which would also have to change if patients were to be able to access them.
“These problems are not insurmountable but will need a lot of careful thinking if they are to be solved,” he concluded.