ArticleBMJ open2025
Evaluating adherence to patient registration paperwork guidelines: a mystery shopper study in English primary care.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate adherence to National Health Service (NHS) patient registration ID guidelines among General Practitioners' (GP) practices.
designA mystery shopper study, including website reviews and phone calls.
settingRural and urban parts of the United Kingdom's West Midlands.
participants85 randomly selected GP practices. PRIMARY AND SECONDARY OUTCOME MEASURES: In January-April 2024, GP's websites were reviewed before phone calls in which our 'mystery shopper' was asked to register without photo ID and proof of address.
resultsOf 85 GP practices, 60 (71%) breached NHS guidance either online or over the phone, with only 25 (29%) consistently following NHS guidance. Phone calls to rural (vs urban) GP practices were more likely to yield refusal of registration without photo ID and proof of address, despite rural (vs urban) GP practices making similar statements online. During some phone calls, practices sought to negotiate a compromise by requesting less robust 'documentation', such as an addressed parcel.
conclusionsGP practices commonly refuse registration to people without photo ID or proof of address, thus creating 'sludge' and undermining access to healthcare especially for poor, vulnerable patients, including immigrants. Changing GP practices' websites would not address this problem if erroneous information is still provided over the phone. GPs and practice managers should ensure that all staff follow NHS guidance to allow registration without these documents.
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