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BP quality targets missed more often in women

GPs are striking twice as many patients from their lists as they were six years ago, figures from the GPC reveal.

In new guidance on removing patients, the GPC said the average three-partner practice was now forced to take such action six times a year.

The figure compares with less than one removal per GP per year when the guidance was last published in 1999.

GPs said the figures were a reflection of increasing violent or abusive behaviour from patients and more breakdowns in doctor-patient relationships.

The statistics, which include patients removed for being outside practice boundaries, also demonstrate the rising workload pressures faced by GPs.

Dr John Grenville, Derbyshire LMC secretary, and a victim of violence at his surgery, said GPs now understood they could remove patients for violent conduct.

He said: 'There is an increase in GPs adopting a zero tolerance approach.'

Dr Lis Rodgers, chair of the professional executive committee at Doncaster West PCT and a GP in the town, said GPs had 'lower tolerance' for unacceptable behaviour and more confidence in their right to remove patients.

She added: 'In the past GPs got paid for bums on seats, but now there is not such a big push to keep lists high, and you have to be clear about practice areas. That is a chance to consolidate your list.'

The GPC guidance reflects changes as a result of the new contract.

GPs now have to warn a patient before removal, apart from in cases of violent or abusive behaviour, and must write explaining the decision after going ahead.

Removal of a patient for clinical reasons or because care undermines target performance is forbidden.

By Joe Lepper

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