GP opposition to abolishing practice boundaries

Abolishing practice boundaries could seriously affect the safety of vulnerable patients, place rural practices at risk of closure and make home visiting very difficult, said the RCGP in a recent statement.

The College’s position is that patients want to be seen by health professionals they know and trust and who will share decisions with them around their care. It believes that patient choice is important but geographically-defined GP practice areas are crucial in efficient healthcare provision.

"Practice boundaries enable GPs to determine how many patients they have on their lists and assess the health needs of those patients so that local services can be planned most effectively. They make it easier and safer for children to be on the same list as the rest of their family."

The RCGP believes that the small number of patients who commute long distances and would like to access a GP close to their place of employment could be accommodated through greater access to walk-in centres, or telephone and electronic consultations with a GP.

Government plans to abolish practice boundaries were also strongly opposed in a motion passed at the recent LMC conference. Here Dr Laurence Buckman also announced the GPC’s intention to stand firm against the policy.

He said: "I can see on the face of it why patients might find it appealing, but I would remind those who are enthusiastic for unfettered choice that their freedom to choose restricts those who cannot exercise choice so easily.

"Unlike politicians, we and all other GPs out there know that this is a barking idea. How does continuity work if the patient can have a GP who, due to distance, cannot visit and who does not know the environment in which they live? What happens to the vulnerable, the criminal, the housebound, and those who should not be allowed to change because their choices are motivated by risk-taking or avoidance or surveillance?

"It’s a proposal which would increase bureaucracy and costs for the NHS at a time when it can least afford it. We will continue to push the GPC alternative way forward, which is cheaper, simpler and will improve access and choice of practice for patients, including those who want to be seen away from home."

Sources: RCGP and Pulse