New Patient Registration Policy

Introduction

This policy outlines the practice approach to new patient registration in line with:

• NHS England Standard General Medical Services (GMS) Contract
• General Medical Services Contract Regulations
• Primary Medical Care Policy and Guidance Manual (PGM)
• Care Quality Commission (CQC) guidance

All practices are assumed to have an open list unless formal approval for list closure has been obtained from the commissioner.

Purpose

• To ensure equitable access to registration for all eligible patients.
• To provide clear guidance to staff on the registration process.
• To safeguard patients, especially those in vulnerable circumstances.
• To comply with contractual and statutory obligations.

Scope

This policy applies to all staff involved in patient registration within the practice, including administrative and clinical staff.

Registration principles

• Patients have the right to register with any practice with an open list if they live within the Practice Boundary.
• Registration must not be refused on the basis of race, gender, age, religion, sexual orientation, appearance, disability, or medical condition.
• Practices must accept allocations from the ICB.
• Out-of-area registrations may be considered but are not mandatory.

Types of registration

Permanent registration

For patients residing within the practice boundary.

Out of area registration

Voluntary for the practice; refusal must be explained.

Acceptance and refusal

The practice will

• Accept registrations when the list is open.

Refuse only if

• The list is formally closed with commissioner approval, or
• The patient lives outside the practice boundary and no out-of-area arrangement is agreed, or Other reasonable grounds may apply (to be documented).

Refusals must

• Be given in writing to the patient either by SMS text message, email or letter, within 14 days of their application.

All refusals will be recorded on a central log.

Registration process

• Patients can register digitally via the NHS “Register for a GP surgery” service or using the PRF1 paper form.
• Registration must be available during all advertised opening hours.
• Patients should be offered pre-registration practice information when possible.

Identification and proof of address

• There is no legal requirement to provide ID, proof of address, immigration status, or NHS number.
• ID may be requested to assist administration but lack of ID is not grounds for refusal.
• Patients unable to provide documentation (e.g., homeless, refugees, domestic abuse survivors) must still be registered.
• Practice address may be used (with “Care of”) if no fixed abode.
• Suspected fraud should be reported to the NHS Counter Fraud Authority.

Safeguarding and vulnerable groups

Children

Children under the age of 16 years must be registered by a parent or guardian, however there may be exceptions to this rule if the child is considered to be vulnerable. The Safeguarding Lead should be consulted if a child under 16 years old attempts to seek registration without parental/guardian consent.

Homeless patients

Register using a chosen address or the practice address.

Migrants, refugees, asylum seekers

Eligible for free primary care regardless of status. Immigration questions on PMS1 are optional.

Prison leavers

Registration should be initiated prior to release.

Veterans

Register, and code as a Military Veteran to ensure access to support.

Patients with reduced capacity

Registration may be completed by a relative, carer, or person with legal authority under the Mental Capacity Act.

Cared for patients

You can register someone you care for, including if you’re a paid, unpaid, foster or young carer. You will be asked for your details and those of the person you’re registering.

Additional support

Where needed, the practice will:

• Provide translation/interpretation services.
• Ensure accessibility in line with the Accessible Information Standard.
• Offer longer or double appointments where appropriate.
• Provide assistance with registration in a private and supportive manner.

New patient health checks

All newly registered adult patients will be asked to provide a blood pressure reading, Smoking and alcohol consumption status, height and weight measurements.

Registration must not be delayed pending health checks.

SNOMED codes should be used to record initial health assessments or declined assessments.

Responsibilities

Reception and administration staff

Process registrations, explain options, and document refusals.

Safeguarding lead

Oversee child registrations, vulnerable patient registrations, and safeguarding concerns.

Practice manager and partners

Ensure compliance with regulations, approve refusals, and maintain permanent refusal records.

Monitoring and compliance

• Permanent refusal records will be maintained and available for inspection by the ICB.
• Regular staff training will ensure understanding of this policy.
• Policy reviewed annually or when new national guidance is issued.

References

• NHS England: Register with a GP Surgery Guidance
• Primary Medical Care Policy and Guidance Manual (PGM)
• CQC Registration Guidance
• BMA: Guidance on Patient Registration
• Doctors of the World: Safe Surgeries Network
• OHID Migrant Health Guide

Date Issued: 16th September 2025
Date for Review: 30th September 2027