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Independents' Day

Revealed: Genuine patients kicked off practice lists in 'heavy-handed' validation drives

Exclusive Tens of thousands of suspected ‘ghost patients’ have been wrongly removed from practice lists and had to re-register with GPs under heavy-handed list-cleansing drives that have targeted the most vulnerable, Pulse can reveal.

A Pulse investigation reveals over half of patients removed from practice lists under PCT list validation drives in some areas have been forced to re-register with their practice, with GPs often blamed for the administrative error.

PCTs are scrambling to hit the Government’s target of removing 2.5 million patients from practice lists by April this year, often targeting the most vulnerable patients, including those with learning disabilities, the very elderly and children.

Data from 53 PCTs released under the Freedom of Information Act reveal some 2,611,958 patients have been reviewed so far. Of those, 6% were removed from practice lists. Across the 24 PCTs able to give full data, 9.8% of the 41,119 patients removed from practice lists turned out to be genuine patients and were forced to re-register in 2011/12.

Extrapolated across the country, this would mean more than 25,000 patients have been wrongly removed from GP lists. The equivalent proportion is 7% so far in 2012/13.

Read the full results of the investigation here

The drive is to ensure practices are not paid for so-called ‘ghost patients’, but GP leaders warn that the ‘heavy-handed’ approach adopted by some PCTs is leading to genuine patients being removed, which damages the doctor-patient relationship and affects patient care.

Dr Barry Moyse, chair of Somerset LMC, said: ‘It’s risky- patients taken off lists will miss out on invitations to smear tests, breast cancer screening and immunisation. It’s throwing the baby out with the bathwater.’

on and off GPs' lists graphic

Some areas saw high percentages of patients removed re-registering. NHS Blackburn and Darwen saw 55% of patients removed from lists re-registering, while NHS Airedale, Bradford and Leeds saw a 13% re-registration rate.

Dr Tony Grewal, medical director at Londonwide LMC said patients believe the GP has ‘struck’ them off the list. He said: ‘GPs have to spend considerable amounts of time explaining to patients that it’s a PCT drive and it’s not done by the GP out of malice.’

He added that patients being removed and having to re-register disturbs practices’ cashflow: ‘If they re-register the capitation payments don’t come in until the next quarter. So you’re losing capitation for two quarters for a patient who still thinks they’re registered.’

Guidance on list cleansing sent to PCTs last year urged NHS managers to target immigrants, students and multi occupancy dwellings, but PCTs admitted children and patients aged over 100 years old were being caught up in the drive to cut practice lists.

Dr Richard Vautrey, deputy chair of the GPC said: ‘This blunt blanket approach taken by PCTs has impacted on many genuine patients, losing their registration with their GP. We have brought it up with the Government on many occasions but they seem to be blind to the problems they’re creating.’

A Department of Health spokesperson said: ‘GP patient lists must be accurate and up to date. Last year there were three million more patients on GP lists than exist in the whole population of England.

‘It is unfair to expect taxpayers to pay for patients who are no longer receiving services from that practice. Before people are removed from GP lists, they must be contacted and given ample opportunity to confirm they are still in the area.’

A spokesperson for the NHS Commissioning Board told Pulse that they are currently developing a ‘single model’ for list validation to replace the plethora of systems currently used by PCTs, for when they take over responsibility for list cleansing in April.


Readers' comments (5)

  • Vinci Ho

    Predictable and politically correct answers from DoH.
    You wonder what kind of human beings are working over there?
    Lack of sensitivity
    Lack of compassion
    Lack of empathy
    Refusal to use common sense
    No wonder Mid Staffordshire disaster did happen!!!

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  • So a mere 90% were ghost patients then?

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  • Vinci Ho

    I tell you what is unfair to taxpayers:
    Paying for these people in DoH who are so remote and constantly engaging reorganisation .......

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  • Has anyone managed to get any proof of posting of the letters said to have been sent to patients?
    In previous sweeps - many years ago - letters were said to have been sent Recorded Delivery (but then PCO couldn't produce any evidence) - and, to add insult to injury, the then PCO would not accept a re-registration at the same address - because a letter had been sent to that address and there was no response...
    Should practices be demanding a back-dated capitation fee, on the grounds that the patient was correctly registered all along?

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  • Now that is a good idea. Backdated capitation fees would stop perverse incentives to cull GP lists.

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