Supporting GP registration for people experiencing homelessness

The training programme has been developed to support GP practice staff and complement the new online GP registration service, to reduce the risk of worsening health inequalities for the homeless population. The Health and Social Care Act 2012 introduced statutory duties on the NHS to “have regard to the need to reduce inequalities” in access to and outcomes achieved by services. There are further duties imposed on NHS England under the Equality Act 2010 and NHS Act 2006 on equality and health inequalities.

People experiencing homelessness are entitled to be registered with a GP, whatever their immigration status. Practices may only decline to register a patient (whether as a temporary resident or permanent patient) if they have reasonable grounds to do so. These grounds must not be related to their race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. There is no contractual requirement to request evidence of identity, immigration status or proof of address and while some practices may request this, they should not refuse registration on the grounds that a patient is unable to produce such evidence. People experiencing homelessness have significant health needs and often suffer some of the worst outcomes. Reducing barriers to accessing healthcare will help improve engagement. People experiencing homelessness may register with a temporary address, which may be a friend’s address or a day centre. The practice address may also be used.

All practices are expected to have processes in place to demonstrate (e.g. practice policy, records of refusals) that it has not refused any registration unreasonably, including refusal on the grounds any patient was unable to provide proof of identity or address or any evidence of immigration status.

NHS England is committed to ensuring homeless patients receive the same level of care as those with permanent addresses.