Safe Surgeries provide hope for vulnerable members of our communities excluded from 76% of UK GP practices

Leading health charity, Doctors of the World (DOTW), is today celebrating the 500 GP surgeries across the UK who have signed up to the charity’s Safe Surgeries initiative. By signing up, these GP surgeries are committing to ensuring that they will provide a safe and secure environment for vulnerable people in their community to access healthcare.

This milestone is particular cause for celebration after an investigation by the Bureau of Investigative Journalism and The Independent found that fewer than a quarter of GP surgeries (24%) surveyed in cities across England, Scotland and Wales would register someone without proof of address, proof of ID or legal immigration status[1].

Launched in 2018, the Safe Surgeries initiative recognises the barriers to healthcare access that exist – particularly for migrants, refugees, street homeless people, and many others in vulnerable circumstances – including administrative and language barriers. GP surgeries who sign up to the initiative are leading by example and working tirelessly to ensure that nobody in their community is excluded.

Everyone living in the UK is entitled to register and consult with a GP. It means we can prevent and treat illness early and create a healthier society for everyone. Yet too many people are left behind, denied access to healthcare, despite having the right to it.

A Safe Surgery can be any GP practice which commits to taking steps to tackle the barriers faced by many vulnerable people in accessing healthcare. At a minimum, this means declaring your practice a ‘Safe Surgery’ for everyone and ensuring that lack of ID or proof of address, immigration status, or language are not barriers to patient registration.

Anna Miller, Head of Policy and Advocacy at Doctors of the World, said: “Doctors of the World is delighted to have reached the milestone of having 500 GP practices sign up to be Safe Surgeries. It means that 500 communities across the country are actively welcoming their most vulnerable and ensuring that anyone who needs it can receive the medical attention they need.

“Access to primary healthcare is the right of anyone living in the UK, yet many GP surgeries don’t recognise their responsibility to some of the most socially excluded members of their community. This has to change if we are going to tackle the health inequalities which continue to challenge our health service.”

Dr Hannah Fox, a GP based at the Lawson Road Surgery in Norwich – which is a Safe Surgery, said: “As a GP I believe that everyone in the community should be able to access appropriate and timely healthcare with ease. If an individual in vulnerable circumstances faces barriers to accessing a GP practice, then GPs and nurses cannot provide preventative care, intervene early and manage long-term conditions. This results in a higher burden of disease and increased mortality for those excluded. It also has detrimental effects on population health, leading to widening health inequalities in our society.  

“This widening gap in health outcomes is driven by the ‘hostile environment’ for migrants which was introduced in 2012 and undermines the core principles of the NHS. As this last year has shown, it is impossible to tackle public health issues, such as the COVID19 pandemic, if we don’t actually provide healthcare to the whole of the community.

“Becoming a Safe Surgery is an important step in tackling these inequalities, preventing exclusion of those in vulnerable circumstances from essential primary care. We need to work towards a more inclusive model of healthcare, and ensure our practices are safe and welcoming environments for all. I encourage all GP practices to sign up and become a Safe Surgery!”

Saleh is a member of the DOTW National Health Advisors, and he has been supporting migrants in accessing healthcare in his community by working in a Safe Surgery in south London: “I am a refugee from Syria, I have been in the UK for five years. I enjoy helping and guiding people who have difficulties registering with a GP.

“In our surgery, we sometimes receive registration forms from patients who want to join our surgery, but they don’t have proof of identity or address. We accept them without these documents because they are entitled to be registered with a GP.

“I know from personal experience that if you don’t have utility bills in your name and have not been able to open a bank account, because you usually need proof of address to do that, it can be difficult to find other documents that will be accepted as proof of address.”

As well as the opportunity to better advocate for patients, becoming a Safe Surgery offers GP practices additional benefits:

• Support to fulfil contract obligations as defined in NHS England guidelines e.g. preventing ID and proof of address being barriers to registration;
• Support successful CQC inspections by helping practices deliver an Effective, Responsive and Caring service;
• Support staff learning and skills-building through free training, information-sharing and resources;
• Membership of a community of providers which actively promotes a better NHS, helping to tackle health inequalities and provide accessible healthcare for those that need it.

To find out more about the Safe Surgeries initiative, download the Safe Surgeries resources, and to find out how to register as a Safe Surgery, visit the Doctors of the World website.

[1] https://www.thebureauinvestigates.com/stories/2021-07-15/most-gp-surgeries-refuse-to-register-undocumented-migrants