Mystery shopping report: GP registration in Greenwich

Overview

Everyone living in the UK is entitled to free primary care. In England, anyone can register with a GP surgery . Proof of address or immigration status, ID or an NHS number is not required and for good reason.

To do so would make primary care much harder to access for groups already often at the sharp end of health inequality.

Forecast data shows 24% of people in the UK (often the poorest and most marginalised) do not have access to identity documents like passports and driving license.

Data suggests whilst 76% of White people have a driving license, the percentage of Black people possessing a driving license is 54%. Other marginalised groups like migrants and asylum seekers, those who are homeless and people from Gypsy Roma Traveller (GRT) communities are also less likely to possess photo identity documents.

Primary care is usually the point of first contact with health services and facilitates entry to the rest of the health system. Improving access to health and care for all and reducing health inequity is a key aim of primary care.

Both nationally and locally , in contrast to policy guidelines, documentation is often a requirement of new patient registration at GP surgeries. Despite reports from Greenwich residents, we were surprised to find just how routinely documentation was asked for, and even when we challenged requests for documentation – how often we were still told we could not join a GP surgery as a new patient without it.

Aims

To review:

• GP registration process for Greenwich residents

• Compliance with current regulations

• Support offered to patients with additional needs

Methodology

Our review was carried out in two parts – telephone mystery shopping and a website audit.

Mystery Shopping: Our mystery shoppers called GP surgeries using two scenarios.

• In the first scenario – our mystery shoppers said they were moving into the area and wanted to register at the practice.

• In the second scenario – our mystery shoppers said an elderly family member, moving into the area from abroad to be closer to family, wanted to register at the practice.

In each round, we asked:

a) How to register at the practice

b) If patients can register without documentation

c) What support is offered to patients needing help to register – such as patients with limited reading/writing skills or patients who are not fluent in English. In addition, we noted how helpful the person answering our call was, i.e. if they were willing to listen to our questions, gave us clear information, and had a polite telephone manner