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How to register new patients

What is the best practice protocol for handling the registration of new patients? By Dr Rodger Charlton

Dr Rodger Charlton: 'The most difficult scenario is where a person wishes to change doctor from another practice within your catchment area' (Photograph: NTI)
Dr Rodger Charlton: 'The most difficult scenario is where a person wishes to change doctor from another practice within your catchment area' (Photograph: NTI)

Depending on where your GP practice is you may have a high turnover of patients, perhaps up to a fifth of your list a year.

Even in a semi-rural practice like my own there are regularly new patients joining. Your receptionists will be well versed on the paperwork that is required and asking for a patient's medical card if they have one.

However, most cannot lay their hands on these easily and then comes the difficulty of remembering who their last doctor was and their address and postcode. So what should your protocol for these patients be? Here is mine and it should clearly guide the receptionist, the patient joining the list and the GP who sees them for their 'new patient check'.

Welcoming pack
The pack should have a sheet detailing what is required by a patient to register, for example medical card and previous address details.

Next, the practice leaflet, which should detail the opening times, how to make an appointment so that a prospective patient may see how your practice perhaps differs from their previous one.

If you have a website, the web address should be prominent.

It should be clear what the practice catchment area is as the commonest question a receptionist will ask is whether a patient can join at a particular address. There is nothing worse than the receptionist not knowing and a message left in the diary for you to make a decision on a particular application with limited information.

Similarly, it is difficult for a receptionist to quiz a patient at the front desk or on the phone.

New patient check appointment
Some practices may not register a patient until they have seen the doctor. For a few practices it will not be possible for a patient to register if its list is closed and receptionists should be made aware if this is the case and perhaps a notice provided in reception.

A patient may be unsure if they wish to join your practice and so an initial consultation to make sure the practice will meet the expectations of the patient before making the registration can perhaps be arranged.

The most difficult scenario is where a person wishes to change doctor from another practice within your catchment area. There may be a good reason for this or it may be that they have been removed from a practice list. If your list is open, then the practice is obliged to accept the patient and the receptionist needs to be clear what the policy is for such potential new patients.

Initial interview
This is an opportunity to initiate a good doctor-patient relationship on a good footing. A welcome perhaps with a handshake, offering the person a seat, introducing yourself and having a chat can be a good start.

Then seeking some details about the patient, who they are and where they have moved from and trying to answer any initial questions they may have about the practice. It is this first meeting which sets the scene for future consultations and will be the one which the patient in particular will judge the doctor and the practice by. It will likely influence their attitude towards the practice and the way they use it.

Depending on your GP computer system it may be possible to get the patient record sent direct to your computer and where this is not possible and a patient is on several medications it may be possible to ask for a faxed summary print out.

New patient check
This used to attract an item of service fee under the old contract and such a fee is now included within the global sum. It is easiest to use a computer template and to complete this while a patient is present measuring parameters such as:

  • Height and weight (and so BMI).
  • BP.
  • Urinalysis (receptionists should provide a container prior to the check).
  • Smoking and alcohol consumption.
  • Family history.
  • Active medical problems.
  • Medication.
  • Past medical history.

All of this can be made easier with a short questionnaire for a patient to complete and such measurements being conducted by a healthcare assistant. It depends on whether as part of your practice protocol a doctor should see a new patient at the first meeting.

In the case of a young child, it can be useful to ask a parent to bring their 'red book' so details of vaccinations may be recorded direct on to the computer.

CPD IMPACT: Earn more credits

These further action points may allow you to earn more credits by increasing the time spent and the impact achieved.

  • Look at your practice protocol for new patients if there is one. Decide if it needs revision and discuss at a practice meeting.
  • Review your practice leaflet and website if you have one and see how this relates to new patient registration and implement. Record any changes based on this article in your appraisal portfolio.
  • Consider with a colleague and reflect upon your current practice approach to potential new patients who wish to change practice/doctor or have been removed from another GP practice list. Log these reflections.

Record all your learning with your free online CPD Organiser

  • Dr Charlton is a West Midlands GP and associate clinical professor at Warwick Medical School

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