GP mythbuster 61: Patient registration

Page last updated: 11 October 2023
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Organisations we regulate

This has been fully updated to include more detail on inclusive healthcare.

General practice can play an active role in improving population health. This is considered in our responsive key question.

Anyone may register and consult with a GP without charge. This is regardless of nationality and residential status.

Members of the public can choose their GP practice. This is unless there are reasonable grounds for the practice to refuse.

See the NHS Constitution.

What does this mean for practices?

The General Practitioners Committee of the British Medical Association (BMA) has published guidance on patient registration. 

It clarifies what’s needed of practices in England to meet their contractual obligations.

There’s an expectation that:

  • practices will help with registrations
  • patients are treated equally when registering with a practice.

Practices may only decline registration if they have reasonable grounds to do so. These grounds must not be related to an applicant's:

  • race
  • gender
  • social class
  • age
  • religion
  • sexual orientation
  • appearance
  • disability or medical condition.

Practices should not refuse registration if an applicant cannot produce their:

  • proof of identity
  • immigration status.

You should record the reasons for any refusal of patients from these groups.

Inclusive healthcare

GP practices provide care to their local population. This includes the most vulnerable in our society.

Practices are in a key position to tackle health inequalities.

It’s essential that vulnerable and socially excluded groups of people can access good quality health care. This starts with being able to register with a GP.

Practices may be asked to register people who are socially excluded. These people typically experience multiple overlapping risk factors for poor health, such as poverty, violence and complex trauma.

This includes:

  • people who experience homelessness and drug and alcohol dependence
  • vulnerable migrants
  • Gypsy, Roma and Traveller communities
  • sex workers
  • people in contact with the justice system
  • victims of modern slavery.

People from these groups tend to have very poor health outcomes. This is often much worse than the general population, with a lower average age of death. This contributes considerably to increasing health inequalities.

See:

What we look at

As a GP practice, you must be responsive and inclusive to the needs of your population. You should also be proactive in understanding the needs of different groups of people and deliver care to meet their needs.

We expect practices to meet their duties, providing emergency and immediately necessary treatment. When a patient does not need this, you only have limited discretion about whether to register the person.

  • We use these regulations when we review if the practice is safe, effective, responsive, caring and well led.

Regulation 9 (Person centred care)

Regulation 10 (Dignity and Respect)

We will look at how you:

  • treat people as individuals and make sure the care, support and treatment meet their needs and preferences. You should take account of their:
    • strengths
    • abilities
    • aspirations
    • culture and unique backgrounds
    • protected characteristics
  • understand the diverse health and care needs of people and your local communities. Care should be joined-up, flexible and support choice and continuity
  • make sure that everyone can access the care, support and treatment they need, when they need it
  • tailor the care, support and treatment to your local population.
  • promote a vision, strategy and culture. This is based on:
    • transparency
    • equity
    • equality and human rights
    • diversity and inclusion
    • engagement with, understanding and meeting the needs of people and communities.

Further information

GP mythbusters