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Active patients wiped from GPs’ lists

By Gareth Iacobucci

Exclusive: GPs are seeing current patients wrongly wiped from practice lists as primary care organisations across the UK step up sweeping list-cleansing exercises in a bid to cut costs, a Pulse investigation reveals.

The East Finchley Medical Centre in Barnet, north London, has been refunded £9,000 after NHS Barnet admitted it had struck more than 600 patients that were still being seen by the practice from its list.

But its successful appeal came as a Pulse investigation gathering data from 103 PCOs revealed that NHS managers stripped more than 100,000 patients from practice lists last year, and plan to ramp up list-cleansing schemes over the next 12 months.

Some 36% of PCOs are currently running list-cleansing schemes, and 51% said they planned to run one within the next 12 months.

Across 37 organisations able to provide data on the number of patients they had removed from lists, a total of 116,476 patients were taken off in the past 12 months, an average of 3,148 per PCO.

Among 25 PCOs able to give financial figures, a total of £3,119,230 was recorded in savings. The largest savings were £646,000 in NHS Sheffield, which removed 9,500 patients from practice lists in the past 12 months, and £500,000 in NHS Berkshire West, which removed 7,734 patients.

In some areas such as Westminster (7,000 patients) and Kensington and Chelsea (5,000 patients), as much as 3% of the total registered population was removed from GP practice lists.

Katherine Lau, practice manager at the East Finchley Medical Centre, which successfully challenged NHS Barnet for three months' lost capitation payments, said her practice was pleased with the rebate, but accused the trust of engaging in ‘cheap' cash-saving tactics.

'It was definitely trying to save money. But that was a cheap tactic,' she said. 'I've had to deal with so many complaints from patients. I had elderly patients crying on the phone. The most alarming was the mentally ill people. It was a complete shambles.'

Dr Helen Clark, medical director of Londonwide LMCs and a GP in Brent, praised the practice for appealing: 'This is a good example for other practices. It is a big issue and we want to establish principles that PCTs should adhere to.'

Some GPs warned they were at risk of unfairly losing thousands of patients because of the aggressive tactics being employed.

Dr Jacqueline Marshall, a GP in Brent, said: 'We're in a situation where still, on 9 June, there will be vulnerable patients who will lose their GP through no fault of their own, either because they hadn't had a letter, haven't understood the letter, or are not capable of responding to the letter.'

Sarah Teather, Liberal Democrat MP for Brent Central, has written to Brent PCT urging the trust to ensure the most vulnerable people are protected.

Ms Teather said: 'It is important that GP's lists are accurate and while I recognise the challenge of doing this in areas of high population turnover such as Brent I have serious concerns about the approach that the PCT has taken. Examples from other areas of London have shown the catalogue of problems that comes with proceeding with list cleansing at too fast a rate.'

'Most worrying is that Brent PCT has not shown how they are planning to protect vulnerable groups of patients such as the elderly, people with mental health problems, and at-risk children from being struck off GP's lists by this exercise.'

A spokesperson for NHS Brent and NHS Shared Business Services - which is carrying out the scheme - said vulnerable patients would have flags removed if practices could provide evidence they were still being seen.

'NHS Brent believes that the most vulnerable patients are often in contact with practices the most regularly and that the evidence that practices can provide will enable them to remove the flag for these people.

'Practices will be informed that should they have very vulnerable patients, who they know are registered but are unable to provide evidence to demonstrate the flag should be removed will have a route of appeal to NHS Brent.'

NHS Barnet was unable to comment.

Dr Helen Clark List cleansing in action

36% - proportion of PCOs currently running a list-cleansing scheme
51% - proportion of PCOs planning to run a scheme within the next 12 months

3,148 - average number of patients removed per PCO

£124,769 - average saving made per PCO from list cleansing in the past 12 months