Accessing GP Services in Tower Hamlets: NHS Safe Surgeries
The Challenge
Migrants, refugees, asylum seekers, and people without a fixed address may face barriers when attempting to register with GP practices, particularly if they are unable to provide proof of address or identification.
To better understand these challenges, a mystery shopper exercise was conducted from December 2025 to February 2026. Healthwatch Tower Hamlets was not commissioned to take up this research, however it was viewed as an important piece of work for our local community.
About Safe Surgeries
To address these challenges, the NHS Integrated Care Board (ICB) works in collaboration with Doctors of the World UK to promote engagement with Safe Surgeries across Northeast London (NEL). The initiative aims to make GP services more accessible for people who may face barriers when trying to register, particularly migrants and other vulnerable groups.
Practices that join the Safe Surgeries network commit to making their registration processes more inclusive. This includes ensuring that patients are not refused registration because they do not have proof of address, identification documents, or due to their immigration status. Practices are supported and have access to guidance, training, and practical resources such as translated patient information materials and staff guidance on inclusive registration procedures.
Our Approach
A total of 31 GP practices across Primary Care Networks in Tower Hamlets were contacted anonymously by telephone to enquire about the GP registration process.
Methodology
A total of 31 GP practices were contacted during the study period. Of these, 15 practices (48.4%) were registered as NHS Safe Surgeries, while 16 practices (51.6%) were not formally signed up to the initiative. Practices were grouped according to their Primary Care Network (PCN) areas (Networks 1–8).
Primary data collection involved anonymously contacting GP practices across Tower Hamlets by telephone and posing as prospective patients seeking registration. The calls aimed to evaluate registration procedures, documentation requirements, availability of interpreter support, and awareness of the NHS Safe Surgeries initiative among practice staff.
Key Findings
The findings showed that:
- Only 29% of practices we spoke to offered both online and in-person registration, while 71% primarily encouraged online registration.
- Although 61.3% of practices reported that proof of address or photo identification was not strictly required, some practices still required patients to live within their catchment area or provided unclear guidance regarding registration requirements.
- In a small number of cases, temporary registration options were available for individuals without a permanent address.
- Although 48.4% of GP practices contacted are registered as Safe Surgeries, awareness of the initiative among reception staff varied. Some staff were able to confirm their familiarity with inclusive registration policies, while others were unfamiliar with the initiative.
- While most practices demonstrated flexibility in registration policies, the findings suggest inconsistencies in documentation requirements, communication clarity, and awareness of Safe Surgeries principles across networks.
Conclusion
The findings indicate that while many GP practices demonstrate flexibility in their registration processes, there are inconsistencies in how registration policies are communicated and implemented.
Improving staff awareness of Safe Surgeries guidance and ensuring consistent communication of registration policies may help reduce barriers to accessing GP services in Tower Hamlets.
