Enter and View: GP appointments and registration in Milton Keynes

Milton Keynes has 30 GP practices run by 27 providers with a combined total of 293,328 registered patients (NHS England, 2018).

Our evidence suggests that the current appointment system is not meeting the requirements of the service users. We found that patients at each of the practices we visited, and those people who contact us about their experiences, all report the same issues. These include not being able to book appointments for ongoing care, limited availability of online appointments, excessive wait times when phoning for same day appointments, and the inability to book an appointment with a nurse online.

We have found that documents that people are asked to provide for registration beyond what is required by the NHS of people to provide and this potentially denies access to care to a proportion of Milton Keynes residents. We had noticed earlier, while visiting various practices for other activities, a number of practices were displaying signage that advised that documents provided at registration would be checked by the Home Office. The person who noticed the signage had sufficient knowledge of NHS requirements to realise that this was not part of the legislation around registration. Subsequently, Healthwatch Milton Keynes contacted NHS England and asked – was this check legal? And who was paying for it?

NHS England advised that checking registration documents with the Home Office was not required by law and also told us that:

“this is not included in the GMS [General Medical Services] contract clauses and is therefore not a contractual obligation for practices. I assume it was carried out at individual practice level. NHSE does not require practices to divulge patient registration details to the home office as practices/GPs are not gatekeepers for such activity. This action is considered to be a breach of patient confidentiality and is not endorsed by NHSE.”

NHS England have requested that practices remove these notices. We were pleased to note that none of the practices we visited during the Enter and View part of this project were displaying these notices. As Milton Keynes has a fast-growing population, we feel that steps to improve accessibility to primary health care need to be put in place to ensure that our residents continue to receive appropriate care at the right time.