This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

A faulty production line

GPs set to face extra crackdown on 'inflated' patient lists

GP practice lists will be scrutinised more than ever after NHS England officials announced plans to standardise its validation processes and crack down on area teams that have not yet begun cleansing patient lists.

Speaking in front of the Public Accounts Committee (PAC) yesterday, NHS England chief executive Simon Stevens said GP lists ‘are inflated’, but said they were ‘a third less so than five years ago’.

But he said that NHS England is procuring new support systems that will allow them to ‘do more’ validation of lists.

This comes after Pulse revealed that thousands of patients have been forced to reregister with their GP due to the NHS England list-cleansing drive, which is aimed at saving £85m and targets the very elderly and children for removal from practice lists.

However, Mr Stevens gave an indication that NHS England will be intensifying efforts to scrutinise GP patient lists.

He told MPs: ‘It is inflated and the extent of the inflation has been coming down quite substantially, so a third less now than five years ago. What we inherited at NHS England was a situation where each PCT and predecessor health authority did its own thing when it came to list validation.

‘So we have a situation where there are 38 different offices around the country that we have inherited that are each doing their own list validation, using a computer system that is 25 years old. Our intention from next spring is to procure a new primary care services back office that will bring national consistency to this right across the country.’

He later added that NHS England would ‘do more’ list validation when ‘aided by a national validation process’. He said: ‘There is work that is happening, but we need to do more of it.’

NHS England chief financial officer Paul Baumann, who was also on the panel being questioned by the PAC about NHS funding, said NHS England would crack down on the one-third of area teams that had not carried out list validation exercises before the end of the year.

He said: ‘In addition to what Simon said, we are going to be mandating during the course of this year, before the end of this year, that every single area team does what most area teams have already been doing, which is implementing the very detailed procedures and guidelines that we have put out in publication back in 2013 to validate the lists.’

He added: ’Two-thirds of them have done substantial amounts of list validation this year, it is true that a third of them have not. Therefore it is our intention not just to wait for the new primary care support services to deal with that but to ensure they are getting on with that job this year.’

A Pulse investigation last month that nearly 12,000 patients have been forced to re-register with their GP since April 2013 after being removed from their GP’s list by managers, following NHS England advice mandating all area teams to validate all GP lists by the end of 2016.

Readers' comments (11)

  • good stuff NHSE, something that has hurt patient care, caused problems. No need to reflect on its impact for practices and patients alike, just do more harm. If NHSE were a doctor, it would have been struck off by now....for life.

    Unsuitable or offensive? Report this comment

  • Having myself been culled from my own GP practice, presumibly for the crime of not being ill often enough, I view patient list culling with great suspicion - ?to ensure GP lists are loaded with high maintaince frequent attenders so NHS England extracts the absolute maximum out of every penny spent, every patient list as burdensome as possible

    Unsuitable or offensive? Report this comment

  • Makes no sense surely unless someone dies then they will stay on your list until they re-register somewhere else. if they don't do that they should remain registered. I don't understand this culling business. The payments system only works if some people don't come often. You couldn't run the service on 60 quid per patient per year if only the regular attenders were allowed to stay registered.

    Unsuitable or offensive? Report this comment

  • NHSE officials on next crackdown. Sorry guys, you are again barking up the wrong tree.
    Maybe you should look at compressed lists rather than inflated ones - a phenomen that has resulted in gross underfunding of Practices.
    With a list of almost 4150 patients, NHSE pays me only for 3605 patients due to the formula which says that children are 'low weightage' patients.
    If you consider that 20-30% of visits in my Practice are due to small children and babies, the payments are heavily skewed in favour of NHSE.
    Eradicate the formula and face reality. If you can't take that step, then stop hammering and blaming GPs for all the ills in NHS.

    Unsuitable or offensive? Report this comment

  • Why don't NHSE look at where 90+% of the money is spent in the NHS secondary care and the internal market.I bet there would be better returns and financial saving to be made when dealing with gaming of that system rather than the comparative pennies looking for ghost on our lists.

    Unsuitable or offensive? Report this comment

  • Another attack on GPs and patients by the ignorant "Daily Mail" style management at NHS E.
    Their last list cleansing deducted the chairman of our county LMC from his GP so that shows how flawed the process is. Simon Stevens you are not fit for purpose.

    Unsuitable or offensive? Report this comment

  • My advice to Practices is - Never deduct a minor if there is no deduction request for the adults in the family or deduct the adults if there is a child being left on your list. Clarify with family and then, if necessary, with KPCA. Else, you risk having a child who is lost to the system and put in harm's way.

    Unsuitable or offensive? Report this comment

  • 'Our intention from next spring is to procure a new primary care services back office that will bring national consistency to this right across the country'

    So, that'll be the privatisation of the current PCS then.

    List validation is unfortunately a necessary evil. Lots of patients aren't deducted when they should be for a variety of reasons:
    - move without registering elsewhere
    - die but the death notification never gets to the appropriate place
    - move abroad without telling their GP
    - die abroad

    In the past, these projects were dealt with on a local basis by organisaitons and staff that had an understanding of their area and population. Now that NHSE are running these projects, they are ill thought out, badly run and result in too many incorrect removals.

    NHSE - one size does not fit all. Different areas have different populations and needs. Stop trying to fit a square peg in a round hole and try listening to the people who actually have the relevant experience. Yes, those PCS staff you are about to send up the river without a paddle.

    Unsuitable or offensive? Report this comment

  • Another ivory tower top-down diktat, which will create problems and angry patients in general practice, but Mr Stevens is far removed from having to put up angry patients isn't he.

    Unsuitable or offensive? Report this comment

  • It is a shambles. The bureaucracy of list cleansing loses 'easily-overlooked' patients, creates huge amounts of work for admin staff and releases no money back to the practices who are seeing great increases in work from temporary residents (largely uncompensated) or rapid turnover of patients (uncompensated if you are a PMS practice). But the arithmetic looks right.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say