NHS Employers conduct negotiations on the General Medical Services Contract with the General Practitioners Committee (GPC) of the British Medical Association. Officials from the Department are not normally present. Within the last six months, an official from the Department of Health attended only one meeting of the Quality and Outcomes Framework (QOF) Negotiating Sub Group, on 23 August 2007 as an observer. Wider meetings between Department officials and representatives of the GPC do also take place regularly but not specifically to discuss changes to the QOF.
Regulations allow a practice to accept a person living outside its boundary on to its list of national health service patients if it wishes to do so. In accepting a patient, a practice has obligations to provide certain services such as home visits. If the practice is unable to fulfil this obligation, it is a reasonable ground to refuse a person living outside a practice area.
Primary care trusts will only grant a general practitioner practice closed list-status once both parties have made reasonable endeavours to keep the list open and the conclusion is that this is not possible.
The Department is currently exploring, as part of the Next Stages Review being undertaken by the Parliamentary Under-Secretary of State (Lord Darzi), whether further action is needed to better ensure patients have more choice of practices with which to register.