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Overzealous ghost-hunting is damaging patient care - it must stop

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Call me a pedant, but I thought it was NHS England’s job to make the health service more accessible for patients. But figures we reveal today show that it is doing exactly the opposite with its three-year rolling programme to validate all GP lists.

The policy – which is well worth a read if you have the time – targets children who miss vaccination appointments, the very elderly and those in multi-occupancy households to see if they are genuine patients and ‘benchmarks’ area teams on their performance in removing patients from GP lists.

The premise of this whole exercise is completely justifiable. After all, natural wastage occurs with patients moving away or dying, so why should GPs pocket a £73 global sum fee per year for a non-existent patient? 

There are good reasons why GP lists must be kept up to date; if they weren’t, how would commissioners track patients and ensure their services are appropriate to the local population? NHS England claims £85m could be saved by ensuring lists are accurate – no small sum in these straitened times. 

But there’s the rub. The problem with these so-called ‘ghost patients’ is that often they are not as spectral as they may first appear. Indeed, Pulse has obtained figures that show thousands of these patients – 40% of those targeted in some areas – have been wrongly exorcised from their GP’s list and subsequently been forced to re-register. 

There can be few more distressing experiences for a GP than to be faced with a patient furious at being removed from the list without their knowledge. Not surprisingly, GPs say this can have a corrosive effect on doctor-patient trust and mean that patients miss vital check-ups or vaccinations.

The system that NHS England has put in place is too crude to meet the needs of the most vulnerable. Patients are informed by letter, but the very young or old may not understand what they are required to do, and surely it is questionable to target homes with multiple occupancy, when these properties are often home to immigrants who are unlikely to be able to navigate the NHS easily.

This scheme needs to be urgently reviewed. It is simply not acceptable for managers to cut adrift large numbers of patients and tell them they must re-register. They must work with GPs to validate lists in a collaborative way or give them the resources to check their lists themselves.

If it cannot be made to work more sensitively, it should be scrapped. It would not be the first over-prescriptive, damaging cost-cutting scheme to bite the dust and it won’t be the last.

Nigel Praities is editor of Pulse

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Readers' comments (2)

  • The GMS contract already has a reduced amount (4% downshift) to allow for ghost patients built into it.

    This fact seems to have been forgotten. Do it but increase the global sum.

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  • the "gain" is the quarter(s) payment lost between removal and the NHS accepting the re-registration.
    Negotiate "backpayments" for all patients removed in this manner who "re register" with the same practice declaring they where in the country and of the belief the practice was able to provide NHS services to them during the period they have been falsely deducted.

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