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  • NMC expands options for demonstrating English language proficiency for overseas nursing staff

    NMC expands options for demonstrating English language proficiency for overseas nursing staff

    Tuesday, 24 October 2017 16:03
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    Tuesday, 26 September 2017 15:55
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    NMC issues advice on responding to unexpected incidents emergencies

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patient dataMay 4 2016

Almost two fifths of GP practices have refused to register new patients, a charity has found. Of 849 attempts it helped make, “31% of practices always refused GP registration and a further 16% gave inconsistent responses; sometimes they would register a patient, on other occasions they would refuse.”

Paperwork was the biggest barrier to registration, with 39% of registration refusals due to a lack of ID, 36% because of a lack of proof of address, and 13% because of immigration status. Just under a quarter (23%) of registration attempts “were met with multiple reasons for refusal.”

The figures come in a report from the Doctors of the World UK (DOTW), highlighting the difficulties faced by vulnerable people in accessing GP services. Receptionists have been singled out as a key concern: “Gatekeeping by reception staff is a significant barrier to GP registration; in 32% of cases the person responsible for registration was not available.”

DOTW has concluded that these barriers will cause difficulties for a wide range of vulnerable people, including homeless people, asylum seekers, undocumented migrants, children, pregnant women, and victims of torture, trafficking, domestic and sexual violence.

The data has been compiled from attempts made by DOTW volunteers while trying to register patients with a GP practice in the period between March and September 2015. It points out that while DOTW clinics are based in London and Brighton, the organisation sees patients from across England.
Registration attempts had involved volunteers phoning the GP surgery closest to the patient’s address, before attempting to secure registration based on the documents the patient had in their possession.

“Everyone living in the UK is entitled to free primary care and GPs are our frontline defence against poor public and personal ill health. NHS guidelines that were issued in November last year state that patients do not need proof of ID or address to register and see a doctor, but inconsistent and unclear guidance in the past has led to confusion in some practices that mean people are still being turned away by surgery staff,” said the charity.

Phil Murwill, manager of Doctor of the World’s Bethnal Green clinic in London, added: “People who attempt to register with a GP are often turned away because of a lack of understanding of frontline staff about the documents which are needed to register.”

DOTW has recommended that GP practice’s administrative and clinical staff are trained on entitlement to NHS care and also that they receive training working with vulnerable patients. “GP practices must ensure their services are accessible for vulnerable individuals and sensitive to their needs, including providing appointment booking options for those without access to a phone or the internet, and that interpreters are used when needed.”

Responding to the concerns, RCGP spokesperson Dr Steve Mowle said: “General practice is the first point of contact for 90% patients in the NHS, so it is important to have systems in place to ensure that those who need medical assistance receive it .

“The last thing we want is for patients to suffer – and be living in the community with potentially contagious diseases – because they have been unable to access healthcare. But we are aware of the barriers that vulnerable groups might face in doing so.”

NHS England’s General Practice Forward View pledges better training will be given to reception staff to advise patients and signpost them to the most appropriate services, he added. “We would suggest that as part of this, reception staff might benefit from training that explains the legalities of who is entitled to care and what documentation is necessary - based on the standard Operating Principles of NHS England, and equivalents in other nations of the UK - so that vulnerable people don’t fall through the gaps as a result of technicalities.”

Links:

Doctors of the World announcement

DotW report: ‘Registration refused: A study on access to GP registration in England’. Published April 30 2016

RCGP response

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