All providers of national health service funded care must handle complaints in accordance with the NHS and adult social care complaints regulations. We expect their handling to be in line with the Parliamentary and Health Service Ombudsman's 'Principles of Good Complaints Handling'.

Nobody should be without a general practitioner (GP) practice. If anyone who has been removed from a practice's list has difficulty in finding another practice, the NHS has a legal responsibility to find them a new practice where they can register.

Primary care trusts have a duty to ensure that everyone in their area has access to NHS primary medical services. Part of this duty entails keeping and maintaining lists of NHS patients registered with GP practices.

Under their contractual arrangements, practices may notify their primary care trust of their wish to have a patient removed from their lists. Practices must have reasonable, non-discriminatory grounds for doing so, and unless the reason is because of violence or the threat of violence, practices are required to warn patients when taking such a step and to give reasons.

Primary care trusts must decide, considering the individual circumstances of each individual case, whether a practice has breached the terms of its contract, and what action to take.

On 1 April 2013, this responsibility moves to the NHS Commissioning Board, where we expect more consistency and effectiveness in handling these issues.

Anyone may approach a general practitioner (GP) practice and apply to join its list of national health service patients, normally by attending the practice premises. Under the terms of their contracts, GP practices have a measure of discretion in accepting or refusing applications to join their patient lists.

A GP practice cannot turn down an applicant oh the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. Other than that, GP practices can turn down an application if the primary care trust (PCT) has agreed that they can close their list to new patients, that an applicant lives outside the practice's boundary area or if they have other reasonable grounds.

In applying to become a patient of a GP practice there is no formal requirement to prove identity or immigration status. However, there are practical reasons why a practice might need to be assured that someone is who they say they are. Consequently, it can help the process if a patient offers relevant documents. Many asylum seekers offer to show their Immigration Service issued ‘Application Registration Card’ (ARC) or official documents that confirm their status.

One of the factors which determine the level of funding GP practices receive under their NHS contractual arrangements is the number of registered patients on their lists. Their global sum payments in respect of patients who are from overseas will not differ from that of other patients. For General Medical Services practices the average payment per weighed patient is £64.67 in 2012-13.

Currently, the local PCT is responsible for establishing and maintaining an accurate list of NHS patients for the practices in its area. From April 2013, this responsibility for the whole of England will transfer to the NHS Commissioning Board.

NHS GPs and hospitals have a duty to identify and charge all visitors that are chargeable for NHS hospital treatment, including those registered with, or referred by a GP. Entitlement to free NHS hospital treatment is based on ordinary residence in the United Kingdom or exemption from charges under regulations. The Department strongly recommends that NHS hospitals use baseline questioning and pre-attendance forms to indicate ordinary residence or exemption from charges and most have an overseas visitors manager to oversee this process.

In recognition that the current rules are generous but also complex and therefore inconsistently applied by NHS staff. The Department has been undertaking a thorough review of charging overseas visitors for NHS care. This included how to establish more effective screening processes across the NHS to identify all of those who should be charged, so that charges are levied appropriately. The initial phase of the review has concluded and its findings are being considered.

The Department has not made nor would be able to make any estimates of the number of overseas visitors or illegal immigrants in this country who may register with GP practices in each of the next three financial years.

Currently there are no formal requirements for a person to provide identity or proof of nationality or immigration status when applying to join a general practitioner (GP) practice’s list of National Health Service patients.

Whilst the care provided by GP practices to their registered patients in England is free of charge, entitlement to free NHS hospital treatment in England is based on ordinary residence in the United Kingdom, or exemption

from charges under regulations, which usually cannot be determined from nationality or immigration status alone.

The department is currently considering a review of charging overseas visitors for NHS care, including how to establish more effective and efficient processes across the NHS to screen for eligibility and to make and recover charges.

Where a general practitioner practice has formally closed its patient list to new patient registrations, it may only accept new applications to join its lists of national health service patients from immediate family members of patients who are already registered with it.

The information requested is set out in the following table, which has been supplied by the NHS Information Centre for health and social care.