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BMA: NHSE out-of-area regulations should be scrapped


By Hiba Mahamadi
20 August 2019

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NHS England (NHSE) should withdraw its out-of-area regulations as they are ‘not in line’ with the commissioning body’s wider policy, the BMA has said in response to NHSE’s consultation on digital-first primary care.

Responding to the consultation, the union criticised NHS England’s proposal to automatically move out-of-area patients to a separate local practice list once they reach a certain number, and called for GP at Hand to be used as an NHS 111 service instead of registering patients.

The BMA said the out-of-area regulations were outdated given the future of digital consultations and that patients can discuss medical issues with GPs on the phone. It said this meant digital providers could prioritise largely healthy patients over those with longer term needs.

The response said: ‘We believe that the out-of-area regulations should be withdrawn as they are not in line with wider NHS England policy relating to population-based health management and are no longer required due to the greater use of telephone, and in the future digital, consultations via existing practices.

‘The regulations, furthered by the proposals in the consultation, give the potential for largely healthy patients and short-term care to be prioritised over predominately multi-morbid patients and continuity of care for a local population in order to profit from this arrangement.’

It added that the proposals would enable the Government to avoid investing in GP practices to help them manage large patient lists.

More resources needed

The response added: ‘The proposals seek to avoid NHS England and commissioner responsibility for investing appropriately in all practices to achieve a fair and consistent digital first offer to patients.

‘Providing the funding, resources and ability for all practices in England to provide safe and appropriate care via a digital first platform would negate the need to introduce the proposals within this consultation and would cause the out-of-area regulations to become redundant.’

‘It comes after it was revealed that patients were ‘getting around’ rationing rules by registering with out-of-area practices.

Earlier this year, NHS England announced plans to make it easier for digital providers to set up practices in deprived areas from April 2020.

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