Elsevier

Health Policy

Volume 118, Issue 3, December 2014, Pages 273-278
Health Policy

Health Reform Monitor
Potential impact of removing general practice boundaries in England: A policy analysis

https://doi.org/10.1016/j.healthpol.2014.10.018Get rights and content
Under a Creative Commons license
open access

Highlights

  • Pilot patients reported better experience than similar patients in national survey.

  • Policy may improve access for sub-group of population (young, working, good health).

  • Drawbacks include managing capacity, ensuring equity, funding urgent local care.

Abstract

In 2015, the UK government plans to widen patient choice of general practitioner (GP) to improve access through the voluntary removal of practice boundaries in the English NHS. This follows a 12-month pilot in four areas where volunteer GP practices accepted patients from outside their boundaries. Using evidence from the pilot evaluation, we discuss the likely impact of this policy change on patient experience, responsiveness and equity of access. Patients reported positive experiences but in a brief pilot in four areas, it was not possible to assess potential demand, the impact on quality of care or health outcomes. In the rollout, policymakers and commissioners will need to balance the access needs of local residents against the demands of those coming into the area. The rollout should include full information for prospective patients; monitoring and understanding patterns of patient movement between practices and impact on practice capacity; and ensuring the timely transfer of clinical information between providers. This policy has the potential to improve choice and convenience for a sub-group of the population at lower marginal costs than new provision. However, there are simpler, less costly, ways of improving convenience, such as extending opening hours or offering alternatives to face-to-face consultation.

Keywords

Patient choice
Practice boundaries
General practice
NHS
Primary care

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Open Access for this article is made possible by a collaboration between Health Policy and The European Observatory on Health Systems and Policies.