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Letter of the week: Unregistered patients cancel out ghosts

The correspondents about list cleansing have all missed an important point (‘If patients don't exist, we can't be paid').

Nobody can justify large numbers of ghost patients, but have GPs' critics thought about where the ghosts go? Unless they die or move abroad – very rare among patients who do not live where they used to – they are living in someone else's practice area and haven't yet registered, which is why they are still registered with their old practice. Hence, their new local practice is, de facto, their doctor, without receiving any payment for it.

The problem of non-registered patients is not given wide publicity. The latest estimate for the population of NHS Berkshire East is about 7% higher than the population  registered with its GPs. Hardly a week passes without my meeting a newly registered patient who has lived in our area for at least a few weeks, and sometimes months. There is a quid pro quo – wherein ghosts are at least balanced by unregistered patients. It is therefore unfair for PCTs to vigorously cleanse lists without taking this factor into consideration.

From Dr Jeremy Platt

Bracknell, Berkshire

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