Andy Burnham, the Health Secretary, has announced that within the next 12 months patients will be given the right to choose their GPs, under reforms to open up real choice in primary care. To achieve this he wishes to abolish practice boundaries to allow people to register with the surgery of their choice based on their own needs. Key issues include:

1. The BMA GPs committee has suggested that most GPs would be comfortable with flexible boundaries. However, major logistical barriers would need to be overcome.
2. Home visits with a GP a long way away could be costly for the NHS.
3. There is likely to be a migration of young, healthy patients to town/city practices, destabilising rural and suburban practices funding and threatening their viability.
4. The patient experience is perceived to be enhanced as patients choose practices convenient to them.
5. City practices could be inundated with lunchtime and evening appointments, which will end up limiting patient choice.
6. There is a risk to practice income if patients desert to rival practices.
7. The arrangements may lead to city/rural alliances or partnerships to overcome some of the perceived difficulties. Although without suitable agreement, this could lead to arguments over who has responsibility to refer and which hospital to refer to.
8. The private sector may look to become involved in the alliances to smooth some of the issues, like home visits for distant practices.
9. The changes would require a major change in the way GPs and other healthcare staff provide their services.
10. The proposals could result in increased costs if patients shop around to get specific treatments as there will be a duplication of investigations.

Contact Tracey Dickens for specialist advice on GP Partnership Agreements on 01206 217326 or tracey.dickens@birkettlong.co.uk