Inside View from a Safe Surgery: “Our concern is more with the patients we aren’t seeing”

In May, the Clapham Park Group Practice in London became the first practice to declare itself a Safe Surgery. Since then, the Safe Surgeries community, launched by Doctors of the World UK, has grown across the country and now counts members across London, Manchester, Birmingham, Norwich and Leeds.

As GP practices that commit to providing safe and welcoming care to everyone in their community, in line with NHS guidelines, Safe Surgeries combat discrimination in healthcare by tackling the barriers faced by migrants in vulnerable circumstances.

Dr. Jenny Akhurst and her colleagues at Clapham Park had already emphasized the importance of inclusive and equitable healthcare. They hoped that joining Safe Surgeries would allow them to learn from others’ experiences and that using the resources would make their ‘welcome’ more visible. Dr. Akhurst explained:

“From a practice point of view, one doesn’t always know if certain patients are facing barriers [to healthcare] because you only see them in a clinical context. We need to make sure that as a practice, we aren’t contributing to any of these barriers. Our concern is more with the patients that we aren’t seeing and Safe Surgeries practices help us reach them.”

Like many practices, they find language barriers at patient registration a challenge, especially when reception is unable to get a hold of interpreters. In consultations, Dr Akhurst always opts for face-to-face interpreters when possible – even if it takes extra coordination.

Patient education is also important, as many patients don’t know that they are entitled to free healthcare and some might be fearful of approaching a GP.

So what makes Safe Surgery policies work for them? Training and shared understanding of what is best practice in terms of patient registration – and the reasons why this is important – are key. For example, if a patient can’t give a stable contact address, maintaining other kinds of contact information becomes even more important for receptionists.

“Training is especially important. GPs and receptionists should not need to ask about a patient’s immigration status. And a patient does not necessarily need to give their home address. We simply want to know that they are currently living within the catchment area.”

Having a Safe Surgeries ‘lead’ in the practice has also been helpful, to advise colleagues who are in doubt and reach out for support from Doctors of the World UK where needed.

Looking ahead, Dr. Akhurst notes that improving understanding of healthcare entitlement and charging among healthcare workers needs to be a priority.

“Most people do not know that everyone is eligible for free primary care. There is huge confusion around charging in hospitals, too, and these questions are more and more ending up with GPs who are frustrated by the lack of patient-centred support for those left vulnerable and without the healthcare they need.”

Along with the other ongoing efforts to challenge these policies, she hopes that Safe Surgeries can help shift the narrative.