Martin Burrows on Registration with GP practices – a big problem for homeless people in London

It was all too common for people to report that they had been refused access to a GP practice.

First published January 2017 by Martin Burrows, Director of Research and Campaigns, Groundswell

Groundswell recently spoke to almost 100 people who are homeless in London to find out about their experiences of using NHS services. Homeless people’s views are rarely sought in public consultation and we wanted to know what should be done to improve healthcare for homeless people.

Two Peer Researchers who have been homeless themselves visited hostels and day centres across the city to conduct interviews with the people who use these services. We spoke to people about a broad range of health services including using GP Practices, Mental Health Services and experiences of being discharged from hospital. One of the findings that really stood out was how difficult rough sleepers and people in insecure accommodation can find it to register and make use of a GP practice. One participant explained it like this:

“When you try to register with a doctor and they send you away because you are homeless you just end up stuck… Some of us have got mental health problems, some physical health problems and a lot of the time it might be those problems that have landed us in homelessness to begin with. When these problems aren’t going to get looked at because you don’t have an address then we are just going to be in a vicious cycle.”

It was all too common for people to report that they had been refused access to a GP practice due to not having identification, having no fixed address or not being able to prove their immigration status. The fact is that it’s against NHS patient registration guidelines, which state that everyone has a right to register with a GP practice, whoever you are and whatever your housing situation.

Being homeless can have a hugely damaging effect on people’s physical and mental health and homeless people often experience complex health issues. We need to make sure that people can get the treatment they need at a GP practice. Not being able to use a GP means that the only place people can turn to is Accident & Emergency Departments, often when the issue has become far worse. Making effective use of primary care is not only good for people’s health – but it saves money for the NHS.

With Healthy London Partnership and Healthwatch, we have delivered 10,000 ‘My right to access health care’ cards to shelters, day centres and other organisations across London to try and spread the word that being denied access to a GP practice is not acceptable.  By mid-January we will have delivered another 10,000 following requests from other organisations for cards.

The cards can be used by people who are homeless to remind staff at GP practices of the NHS England registration guidelines. These state that to register and receive treatment at a GP practice:

  • You do not need a fixed address

  • You do not need identification

  • Your immigration status does not matter.

The cards include Healthwatch’s national helpline number which people can call if they continue to have problems.

People who are homeless often have more pressing survival needs to deal with before they seek help for their health needs.  However, while health may be one of a number of competing priorities, the people we spoke to were very clear that they wanted the opportunity to improve their health. It’s for this reason that we need to remove as many barriers as possible to using the NHS.

People who are homeless have as much right to healthcare as the rest of the population. We hope that these new rights cards will enable homeless people to access the vital healthcare they are entitled to and so desperately need.

The consultation was funded by Healthy London Partnership’s London Homeless Health Programme. The full report based on Groundswell’s research, More than a statistic, can be found on the Healthy London Partnership website.

The my right to healthcare card