Tens of thousands of English patients have lost access to GP home visiting services because they have taken advantage of new choice rules, it has been reported.

The NHS introduced new rules three years ago allowing patients to register with practices outside their home area. But as part of the deal GPs were exempted from any requirement to make home visits to these patients.

Some clinical commissioning groups have commissioned services to ensure home visits are available for these patients – but many have not, the Health Service Journal reported.

The last figures, in October, showed there were more than 82,000 people registered with practices outside their home area. The numbers have been swelled since then by the launch of the GP At Hand service in London – which has attracted more than 10,000 patients.

The journal obtained details from about half of the 207 English CCGs of their arrangements for home visiting for these patients.

They found 64 – with nearly 20,000 of these patients, that had home visiting services.

But another 39 were unaware of the issue or had not commissioned services.

Dr Richard Vautrey, chair of the British Medical Association’s GP committee, said: “As more patients are being encouraged by some providers to be registered under out of area arrangements, it is concerning that so many CCGs have failed to put in place home visiting services to provide safe care for these patients should they be too ill to travel to their new practice.

“If commissioners are going to support providers that are using the out of area registration arrangement to rapidly expand their lists they must also ensure a comprehensive coverage of home visiting arrangements across the whole of the country.”

Dr George Farrelly, a GP in Tower Hamlets, described the policy as “train wreck”, creating unsafe conditions for patients who might become unwell at home.