Too many GPs deter CCers from signing up at surgeries

September 2017 - A new survey shows some GP practises seem to be ignoring official NHS guidelines and refusing to accept liveaboard CCers and their families. The figures also suggest the refusals are deterring other boaters from even trying, as Alec Wood discovered,

The findings of a survey by the London branch of the National Bargee Travellers Association (NBTA) show that nearly four in ten (36 per cent) have had problems registering with a GP because they have no permanent address and more than 30 per cent haven't even tried to register.

Just a third said they hadn't had a problem accessing a GP despite the fact that there is no requirement to have a permanent address to register and NHS England policy is very clear about it.

NBTA deputy chair Marcus Trower said: “We have come across many Bargee Travellers who have been refused by a GP. Many GPs ask of prove of address before registering someone.

“Most Bargee Travellers can't prove an address because the nature of being a Bargee Traveller, we have no permanent mooring.

“I had an upward struggle to get a GP to register me. There is no law or government policy saying the you need proof of address to registering with a GP, however, many GPs still demand proof of address.”

Marcus believes the fact many boat dwellers have had problems accessing a GP creates a climate amongst the Ccer community, that if you don't have a permanent address can't register, “that, in turn, causes others to not even try.”

Marcus is clear that the GP practices at fault need to be brought to book: “We believe, demanding proofg from someone who can't provide that proof due to the nature of who they are, is discrimination.”

Cam Tsang who works for Public Health England on GP data said in a personal capacity: “Most people in the UK are registered with a GP. A common barrier for hard to reach communities having problem accessing GP services is the belief that you need proof of address to register.

“Although many practices ask for proof of address, they are not allowed to refuse registration on that basis. Having seen the results of this survey, it seen to me that more needs to be done to improve boat dwellers without a home mooring access to GP services.’’

NHS England which writes policies for GPs to follow, has a written policy since 2013, that states, “The absence of a permanent address is not a barrier for a person with ‘no fixed abode’ to registering with a GP practice.”

Despite that, four years later there are still GPs that are erecting a barrier against people without a permanent address.

Marcus Trower said: “Boat dwellers without home mooring have a right to health care. We have published a help sheet on registering with a GP. We are also working on making GPs aware that our community has the same rights as anyone else to health care.”

The NBTA helpsheet says:

Registering with a GP as a boat dweller without a home mooring

Any British or EU citizen has a right to register with a GP to access primary care services. It doesn’t matter what anyone says that is your right.

However, GP practices don’t always accept that straight away and will demand proof of address. They might even tell you that it is impossible to register you without proof of address because a higher authority will not let them.

This is not true. GP practices have always had the discretion to register patients out of their catchment area and having no proof of address is not a legitimate reason to refuse your registration.

The NHS is legally obliged under the Health and Social Care Act 2012 to reduce inequalities between patients and this includes improving access to healthcare services for travellers.

According to the following NHS guidance, GPs must allow people without a permanent address (no fixed abode) to register at their practice when the practice is open to registering new patients, see the following link:

http://www.england.nhs.uk/wp-content/uploads/2014/05/who-pays.pdf

Some GPs will register travelling boat dwellers without any hassle. Simply go and register and provide an address where you would like them to send you letters in the post. If you don’t have an address, ask them to put down the address of the practice.

If for some reason other than they are not registering any more, they refuse to register you at the practice, do the following:

1 - Ask to talk to the GP or practice manager, if they are not around request that they phone you back and you want them to state the reasons in writing as to why they are refusing to let you register at the practice.
2 - If you do not get a call back and they are still refusing to let you register, bring them a copy of the above NHS guidance document which outlines that they should register you and refusing to register you because you are a traveller IS discrimination.
3 - Make sure you write down when you tried to register and any other details such as the name of the person/people you spoke to at the practice and any quotes as this will be useful later.
4 - If they are still refusing to register you, and they might, write an email to the GP’s Clinical Commissioning Group (CCG).

Writing to your Clinical Commissioning Group:

You can find out which CCG they belong to on the NHS website by searching the name and/or address of the practice. In the email or letter to the practice, state that you live on a boat without a home mooring and that the GP practice is refusing to register you as a patient.

Attach a copy of the NHS guidance document above and why they shouldn’t have refused you. Please see the attached template letter, amend as necessary and make a note of when you send things out.

Some CCGs might get back to you and are helpful but sometimes they may not get back to you. If you do not hear from the CCG or they are not helpful, you should write to NHS England.

Again, email or send a letter to NHS England explaining that the GP practice has refused to register you, include dates of when you have contacted the GP practice and CCG; and that you are still being refused registration at the GP practice.

Please see the attached template letter, amend as necessary and again make a note of when you send things out.

Contact details for NHS England:
Email: england.contactus@nhs.net
Post: NHS England, PO Box 16738, Redditch, B97 9PT

NHS England should get back to you and say that you should not have been refused registration and to tell you to tell the GP practice that NHS England said they should register you.

Then send a letter or email to the GP practice saying you have talked to NHS England and that you shouldn’t have been refused registration at this practice and include a copy of the letter/ email from NHS England. Please see the attached template letter, amend as necessary and make a note of when you send things out.

This worked for me, I got a letter from my GP practice saying I can register, I went to register and overall I have had no problems since registering.

This advice has been got through experience and research; please send your experience to nbtalondon@gmail.com so we can always improve our advice.

You can access the template letters here: https://nbtalondon.wordpress.com/2015/10/05/registering-with-a-gp-as-a-boat-dweller-without-a-home-mooring/

Photos: Part of the online registration procedure.