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Independents' Day

I ain’t afraid of no ghosts

Editor’s blog

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NHS Fraud has decided to prioritise the shocking fraud that happens in GP practices every day, when they heinously make money by deliberately failing to remove patients from their list.

You have to wonder what goes through the mind of some NHS managers. It would have taken the managers at NHS Fraud a single phone call to the BMA, the RCGP or even NHS England to realise how ridiculous their suggestion is.

First, previous attempts at these list-cleansing drives have invariably shown that practices are good at maintaining their records, and a high number of patients chucked off have been genuine.

There is no scandal here – except the misinformed strategy in the first place

Second, the fact is that funding for these ‘ghost patients’ – those that are still registered with a practice who have died or moved away – is already built into the funding. Ie, practices’ funding is already being reduced because everyone knows it is impossible to have real-time info on all these patients.

Finally – and most egregiously – is the insinuation, as the RCGP rightly put it, that GPs are a bunch of fraudsters out to make money unfairly. This is all the more galling after NHS England have already appointed Capita to audit list-cleansing exercises.

Practices should not be afraid of this drive from NHS Fraud, because there is no scandal here – except the misinformed strategy in the first place.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (5)

  • Azeem Majeed

    Good points Jaimie. All methods of funding primary care have strengths and weaknesses. Where capitation is used to fund primary care services, list inflation is an inevitable consequence.


    The main alternative - funding by activity – is not something that the NHS is likely to implement, even though it would link payment directly to workload. The current capitation-based system of funding NHS primary care is a very good deal for the government.

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  • Informative and brilliant! Thanks!

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  • Sadly there are a very small number of GPs who do deliberately and dishonestly manipulate their list size to increase income.
    It's difficult not to sympathise after years of abuse and underpayment, but this is still fraud.
    Pretending it does not happen will not make it any less true.

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  • I am not even sure how this can be done. Perhaps I am naive. Anyway, I have a few ghost patients unbeknownst to me. That is not fraud. It is the language of managers that is intensely annoying,
    to me, it is a resignation issue. If they say nasty things about us GPs knowing it to be untrue, then we should resign from GP land or get paid per consultation,

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  • Everyone is shrugging their shoulders and just aiming for retirement.

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