Travellers turned away from GP surgeries despite NHS guidance

Travellers and other vulnerable groups without a fixed address or proof of ID are being turned away from GP surgeries despite NHS guidance that they should be treated, a charity has claimed.

The Friends, Families and Travellers (FFT) charity issued the warning after a “mystery shopper” exercise where a prospective patient who said she was a traveller without proof of address or ID contacted 50 GP surgeries.

Of those, 24 refused or were unable to register the patient, 17 practices said they would not register people without proof of identification and 12 GP practices said they would not register people without an address.

Groups who have no fixed address include asylum seekers and refugees, those in contact with the criminal justice system, homeless people and people who have suffered domestic violence.

NHS guidance states that registering to become a patient should not require proof of identity, address or immigration status.

But the FFT research showed that all but two of the practices that refused access to the mystery shopper were rated “good” or “outstanding” by the Care Quality Commission. In the other two cases, the GP surgery had not yet been inspected.

The exercise suggested “really vulnerable people are losing out,” said FFT’s Sarah Sweeney. “Our health system is one of the safest in the world – and it is not right that we are failing on such a simple measure.”

NHS England said the findings were not robust. “This is a survey of fewer than 1% of GP surgeries and everyone in England has the legal right to choose their own GP,” a spokesperson said. But campaigners said the findings were indicative of “longstanding and stubborn issues around access to primary care”.

One woman, Kit Mattingly, said she “hit a brick wall” whenever she tried to be seen by a GP. “The process is soul destroying,” the 56-year-old said. “You know your rights but you know it is going to be a battle, no matter how kindly you tell them.”

She was badly affected by a visit to a surgery five years ago, when she was questioned in front of a waiting room full of people after finding a lump in her breast. “I had to have this confrontation with the receptionist about my right to be there in front of the entire waiting room. It was embarrassing. My confidentiality just went straight out of the window.”

Situations like these leave some feeling pushed into using their friends and families’ details so that they can register quickly, she said. “It pushes us into having to circumvent the process. Imagine sitting with your mate in the pub and you are asking to borrow their address to register. It’s not fair, we shouldn’t be in that position.”

Mattingly has since been diagnosed with breast cancer and is waiting to hear whether it is terminal. She believes that her late diagnosis could have been avoided if she had been able to more easily access care. “I didn’t pursue my rights because I knew it was going to be too difficult and for me that has proven to be potentially fatal.”

Ivy Manning, who works for FFT, said Travellers could also find themselves waiting for hours in accident and emergency departments for minor issues after being denied access to a GP. “Imagine having to drive 100 miles to the hospital because your son has tonsillitis, and then waiting another two days [to be seen],” she said. “It’s embarrassing. You feel like you have to justify your right just to be in the same space as another person.”

Ruth Rankine, the deputy chief inspector of general practice at CQC, said: “Today’s findings by Friends, Families and Travellers are concerning. It is not acceptable to deny someone registration because they do not have a fixed address. That is why, when we inspect, we ask practices to show us how they provide effective care that responds to the needs of particular population groups, including people whose circumstances may make them vulnerable.”

Prof Helen Stokes-Lampard, who chairs the Royal College of General Practitioners, said the guidance was clear on the subject but added that there was confusion at some practices, “particularly in terms of registering, deregistering and reregistering more transient patients”.

But she added: “The consequence of not doing this can mean patients, often in vulnerable and disadvantaged groups, lose their access to essential care and services, and that isn’t something that any of us want.”


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