Evidence across the Healthwatch England network suggests that homeless people are disadvantaged in their access to healthcare.

We decided to find out how easy it is for people who don’t have an address to register with a GP in Buckinghamshire.

What did we do?

We worked with a volunteer from Wycombe Homeless Connection (WHC) who rang 37 practices and two branch surgeries to register someone being supported by WHC who was homeless and ‘sofa-surfing’ with a friend who lived near the practice. Sofa-surfing is an often-hidden form of homelessness where people find a temporary solution by staying with family or friends.

What did we discover?

Our results revealed that 80% of the practices contacted provided a helpful response such as demonstrating a can do attitude to making sure the person could get treatment or offering to find out relevant information.

However, our results also show a wide range of approaches taken by GP practices. In some cases, the practice policy (as portrayed by the response) did not seem to be aligned with NHS England’s ‘How to register with a GP’ patient leaflet. And even when the response was helpful, it was often not aligned with NHS guidance.

NHS guidelines say that GP services cannot refuse to register someone because they are homeless, do not have proof of address or identification, or because of their immigration status. GP surgeries can only refuse to register someone if they are already full or if the person is living outside the practice area – and they must explain this in writing.


A smaller number of practices were not helpful. This means the process of registering as a person with no fixed abode is not as straightforward as it should be. This is important as this is a vulnerable group some of whom may easily be deterred by unnecessary barriers to registration, which could directly impact their health and wellbeing.

Our recommendations

We recommended that:

  • the CCG and GP Federations use their communications routes to raise awareness of this issue and help to ensure a consistent approach
  • practice websites include a link to the NHS Choices webpage that gives information about how to register for a homeless patient (as well as other groups such as asylum seekers, refugees and for the gypsy, traveller and Roma communities)
  • practices ensure staff are familiar with this guidance

What are we doing to ensure these are delivered?

  • We have shared this report with the Buckinghamshire CCG and the Bucks GP federations: Fed Bucks and Medicas
  • We will also publicise the findings so that each Practice’s Patient Participation Group can consider how they can help
  • All our reports are shared with Healthwatch England as the independent national champion for people who use health and social care services.


No address, no problem: registering at the GP with no fixed abode

Published on 25 May, 2018 (updated 17 Jun, 2019)

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