Funding of most primary medical care practices is largely dependent on the number and characteristics of the patients registered with that provider. In addition, quality and enhanced service payments are also usually based on delivery of care to the patients registered with that practice. Therefore, any system of dual or multiple registrations would fund more than one provider to deliver care and services to the same patient—doubling the costs, while at the same time complicating the care management and co-ordination of care to such patients. This would have consequences for the continuity of patient care and ensuring a single comprehensive and up to date patient record. There would also be complicating factors in determining allocation of resources for the provision of hospital and community health services to primary care trusts should patients be registered with different practices in different primary care trusts.
Following the publication of Lord Darzi’s “Our NHS our future” interim report for the NHS next stage review, the Department is currently considering what other new models might enable patients to switch GPs more easily and register with GPs outside where they live.