Adherence to guidelines on documentation required for registration to London GP practice websites: a mixed-methods cross-sectional study

We thank Hodson et al.,¹ for this excellent study, which explores the restrictions to GP registration for minority populations. GMC duties of a doctor highlight the duty to never discriminate against patients, which is a core value to us as medical students, and the NHS. We appreciate the authors’ efforts in showcasing a great problem in society; however, certain aspects need addressing and we would like to make some contributions.

Whilst we commend the straightforward and comprehensive nature of the methodology, the study is limited by its selective attention, within the UK, to London. This is further exhibited by the limited coverage of only 7.5% of GPs and 10 out of 33 London boroughs. Therefore, efforts to generalise the study’s findings across the UK are limited, and we wonder whether other practices may operate differently, and to what extent.

Moreover, several points the authors raised appear - though pertinent - remarkably assumptive. Potential implications of restrictions to GP registration were addressed, such as individuals with chronic diseases unable to receive check-ups, and the impact of turning away patients in need of emergent treatment. However, we wonder how such events actually transpire in practice, despite the misleading information on websites. Thus, we question the validity of the authors’ discussion without a quantitative investigation into these events.

Regarding future research, we would suggest practice staff to be included in the qualitative study because it is important to consider their viewpoints given their experiences with patients who may have been denied registration, reflecting the policies stated on GP websites.

Despite many patients being denied registration at GP practices due to their inability to present the correct documentation, more research should be conducted on whether or not denying registration has any negative implications for patients and their health. Furthermore, to what extent are these consequences significant?

Reference 
1. Hodson N, Ford E, Cooper M. Adherence to guidelines on documentation required for registration to London GP practice websites: a mixed-methods cross-sectional study. Br J Gen Pract 2019; 69(687):e731–9.