Episode 099: Exploring the reasons why general practice staff are reluctant to register undocumented people

In this episode, we talk to Dr Kitty Worthing, a GP registrar working for the Sheffield Teaching Hospitals Trust about work she did whilst working as an academic clinical foundation doctor and then clinical fellow at Queen Mary University.

Paper: Reluctance to register: an exploration of the experiences and perceptions of general practice staff in North East London

Available at:

Previous research shows that people are often refused GP registration if they do not have access to documentation, highlighting a discrepancy between guidance and practice that has not been previously explored. Current third sector initiatives to improve inclusive registration have largely focused on reiterating guidance and explaining to staff why people may not have access to documentation. This study found that reluctance to register this group was common, and reluctance was generally fuelled not by lack of knowledge of the guidance, but by workplace and resourcing pressures, and moral judgements concerning who should be entitled to NHS services based on immigration status. The perceived practical and financial burdens relate to overall increases in workload and the current funding model utilised in general practice. Initiatives to improve access must acknowledge such concerns, alongside addressing the wider malign impact of the ‘hostile environment’ policies on individual staff decision making.

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