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Choice Of GP Practice-Out of the Area Registrations

Updated on 23 November 2015, 922 views

NHS England released guidance on the new out of area patient registration (choice of GP practice) arrangements during November 2014, click here to access this. 

What does this actually mean?

Within the guidance that has been issued it identifies 2 elements to this scheme which are:

Out of area registrations – changes to the GMS contract enables you to have patients with a registration status of ‘out of area registration’.  Practices do not need to opt in to provide this it will be the choice of the practice as to whether you offer this option to patients when registering
In hours urgent primary medical care enhanced service – Where patients choose to register out of area, when they have an urgent care need NHS England working with CCGs need to ensure they can access urgent primary medical services from the 5th January 2015. You can choose to opt in or out of providing this; there is no requirement to undertake this service. 

The following provides guidance in relation to out of area registrations:

1.  Process for registering a patient as out of area:

Completion of GMS1 or equivalent registration form
Registration on GP system as normal with a note on the registration page of out of area, the following provides the agreed text

Information on how to access urgent care arrangements in the event the patient becomes unwell at home to be given to patient, however in the first instance they should contact their registered practice

2.  Funding mechanism for out of area registrations

You will receive the same funding (GMS/PMS) as you would normally receive for any other NHS registered patient.  This is being reviewed and consideration is being given on a small reduction in capitation payments for these patients to assist with funding the urgent care needs when home.  Further detail to follow on this.

3.  Existing patients

4.  Registration Status 

5.  Students:

6.  Assigning patients

7.  Registering patients

When patients who live outside your practice’s area requests to register with you, you will need to decide the following:

*We have sought clarification  around this sentence and this means practices may wish to register patients in the normal way (as you have always been able to do with patients outside of your boundary) or you can choose to register the patient under the out of area scheme. 

Not register the patient. The ability for GP practices to refuse registration on the grounds the patient lives outside the practice area remains unchanged and thus ensures the new arrangements for out of area registration apply on a voluntary basis.

Click here to see a flow diagram that takes you through the steps of what needs to be considered if a patient is outside your boundary and requests to register

The following provides guidance to the in hours urgent primary medical care enhanced service:

The In Hours Urgent Primary Medical Care Enhanced Service is the second element of this and is technically separate from the out of area registration element.  This will be needed when an out of area patient is unwell when at home and requires urgent care.  NHS England working with CCGs need to ensure they can access urgent in hours primary medical services from the 5th January 2015.  

As this is an enhanced service you can choose to opt in or out of providing this, there is no requirement to undertake this service. 

To view the service specification please click here:

1.  What will you have to do if you choose to sign up to this?

If you wish to sign up to this enhanced service you will need to provide the following:

2.   How will this be monitored?

3.  What is the payment for this?

NB: We are seeking clarification around the implications for dispensing practices and also if this will increase MDU/MPS premiums.  We will provide an update on this as soon as possible

4. When can a patient access the in hours urgent primary medical services?

Click here to see 3 different scenarios and whether a patient can access the in hours urgent primary medical service

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