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FARNDON HEALTH CENTRE. MAP OF PRACTICE AREA
All GP practices have a geographical practice area. Anybody who lives within the Practice Area has a right to register with the Doctor who's area they live in, provided that practice has an open list and is accepting new patients. There are a few circumstances where a practice can not get any larger so the list has to be closed ( see details ).
In an urban area most addresses will be covered by the area of two or more practices, so there should never be a problem, even if one particular practice may be less popular for whatever reason. However in rural areas ( like ours ), there will be some areas that are only covered by one practice, in these circumstances there be less choice.
Most Doctors have a few patients who live outside of their practice area, this usually arises when people move house but do not wish to change Doctors. Some people may "forget" to register their change of address, or when the registration is updated it can be easy to overlook the new address being out of area. It is at the Doctor's discretion whether or not to register a patient outside of the area. A Doctor has an obligation to treat patients who are resident in his area, but there is not a right to remain under a Doctor's care if the patient moves out of his area. (however much they may like their previous Doctor ).
This is not Doctor's wishing to be difficult, There are real problems with keeping outlying patients on the list.
The total number of patients becoming too large for the size of the practice, leading the practice to close it's list so that people moving into the area can not join their local practice. It seems unfair for distant people to get the benefits of the practice at the expence of those up the road being turned away.
It may be difficult for outlying patients to get into the surgery if they are not well, and they end up relying on home visits instead.
The very limited time available for house calls being taken up with travelling to outlying patients, to make visits that would not have been needed if the patient was close to the surgery.
The Doctor not being close to the surgery and his other patients should a real emergency happen.
Problems with out of hours emergency care.The out of hours service that is used by the practice may not be prepared to visit patients who are outside of the practice area. The out of hours service is not required to visit out of area, and by taking the duty Doctor too far away from the practice the other patients are put at risk, or face unreasonable delays.
For these and other reasons all GP practices must have a clearly defined area, and normally it would be expected that this is "their patch" and that they should not be involved in the care of people living outside of that area.
We fully appreciate that there will be occasional circumstances when a change of Doctor would not be in the patient's best interest, (for example a terminally ill parent who goes to be cared for at his son or daughter's house where the son / daughter lives outside of the practice area). In special or difficult circumstances like this, we would want to take a pragmatic approach. Provided that the distance is reasonable, we would of course keep the frail parent on our list if that is what they wanted.
We would certainly never remove a frail / elderly or seriously ill patient from the list because of a move just outside of our area. If the patient himself decided that it would be better to register with a more local practice, or if the distance was such that there is no option, then we would happily liase directly with the new GP so that their practice is fully briefed on the problems and treatment plans, before the move actually takes place, so as to ensure continuity of care.
