Bonkers, bonkers, bonkers.
The leaflet sent out was just like a bit of junk mail - several patients report nearly throwing it straight in the recycling.
I note somewhere it was reported that practices would be invstigated if there was a higher than average incidence of opt outs. That would be approx half of practices.
If you offer choice you have to respect people exercising that choice.
Just in case you aren't clear about my view - its bonkers!