Why Safe Surgeries Is Essential for General Practitioner Practices in the UK
By Katherine Taylor, UK Health Advisor and GP Champion Organisation: Doctors of the World (DOTW) UK
Everyone living in the UK is entitled to register and consult with a family doctor. As a General Practitioner (GP) in London I have seen how crucial it is for individuals to be able to speak to a family doctor or nurse, but it wasn’t until I started to volunteer at the Doctors of the World ( DOTW UK) clinic that I realised there are many more people in our community who are not accessing the healthcare they are entitled to.
During my 5 years as a volunteer, I have become acutely aware of the difficulties many people in vulnerable circumstances face when registering with a GP. At our London clinic, DOTW UK helps almost 2,000 people every year who have been unable to access NHS services, they include pregnant women, survivors of trafficking, undocumented migrants and people who have fled war. On average, DOTW UK patients have been living in the UK for 6 years without seeing a GP as they frequently encounter barriers when trying to register at their local surgery, and many are ultimately turned away. The most common reason for patients being refused registration is because they are asked for identification documents such as proof of address, which many people in vulnerable situations or unstable housing are unlikely to have. This especially affects homeless people, survivors of torture or trafficking, people whose documents have been stolen or those fleeing violent situations. NHS England guidance states that if a patient says that they live within the practice catchment area but cannot produce proof, they shouldn’t be refused registration on that basis. However, lack of paperwork was the most common reason for refused registration; lack of photo identification (34%) or proof of address (33%).[1]
Other barriers our patients face include a lack of understanding of how to access services, language and interpretation difficulties and fear of arrest. Until recently, the Home Office used information from NHS patient records to track down migrants for immigration enforcement purposes, and this made many of our patients too frightened to seek care. Due to a successful campaign and lobbying earlier this year, the policy was amended, but for many patients the fear and mistrust remains.
As a Doctor and London GP Champion for DOTW UK, I’ve seen how important it is to provide a welcoming and equitable service for all patients. In response to the difficulties faced by the those we see in our clinic, we have developed the Safe Surgeries Initiative which aims to improve access to healthcare for excluded people by driving practice change in the NHS. We offer training to professionals working in primary and secondary care and host a supportive network of GP practices who are committed to delivering inclusive and accessible services for everyone in their community. Alongside patient benefits, staff are also empowered to introduce and adhere to inclusive registration policies and support all patients — regardless of their circumstances.
While we are very lucky to have the NHS and the excellent services it provides, far too many face potentially life-threatening barriers in accessing the care they are entitled to. This is why we need to work together to build and strengthen the narrative of inclusivity in primary care, follow a Safe Surgeries model, and ensure no one in our community is denied their right to care.
[1] Doctors of the World, Registration Refused: A Study on Access to GP Registration in England (update 2017): Ihttps://www.doctorsoftheworld.org.uk/Handlers/Download.ashx?IDMF=0d7b55a4-5f52-4384-90e1-868145c3f6a5
For more information and to join the Safe Surgeries community, visit our website.
