GP list-cleansing savings will be reinvested into practices, pledges NHS England

NHS England has pledged that money saved through its ongoing GP list-cleansing exercise – which has already removed hundreds of thousands of patients – will ‘remain within general practice services’.

The commissioner said its analysis indicates there are ‘significantly more patients’ recorded on GP registration lists than would be expected based on the Office for National Statistics (ONS) population estimates, and that some of this difference arises from people ‘who have left the country without notifying their practice or formally deregistering’.

It comes after GP leaders warned that practices were losing tens of thousands of pounds due to the process, which seemed to have affected deprived practices the most.

But NHS England has now said that patients ‘are not identified based on ethnicity, nationality or any other protected characteristic’, and that the exercise instead uses a ‘range of demographic and administrative indicators’, alongside statistical modelling, to identify patients ‘who may no longer be resident in England’.

These indicators are then subject to a series of further checks ‘before any action is taken’, the commissioner said.

According to NHS England, patients are not removed from a practice list solely because they do not respond to a single communication, since the programme relies on a ‘combination of information sources, validation processes and safeguards’, and in the event that a patient is removed in error, arrangements are in place to support ‘rapid’ re-registration.

A group of LMCs previously demanded a parliamentary investigation into how the process has been approved.

Separately, the LMC Support Network wrote to the health secretary and NHS England demanding a pause of the exercise and a published methodology underpinning it. The letter was signed by 74 LMCs across England.

NHS Digital data showed that 458,188 patients have been removed from practices’ lists in England since October last year.

Patient list sizes are part of the global sum funding allocation formula, meaning reductions in lists leads to a reduction in funding.

In a letter to practices today, NHSE primary care director Dr Amanda Doyle said: ‘We also understand there are concerns regarding the potential impact of this work on practices.

‘Maintaining accurate patient lists is important to ensuring that NHS resources are distributed fairly and more closely reflect the population receiving care.

‘The Government remains committed to the overall general practice funding envelope for 2026/27, and funding released will remain within general practice services and be reinvested accordingly.’

She added that NHS England is ‘undertaking further work’ to understand distributional impacts and is working with ICBs to identify ‘the small number of practices that may experience disproportionate effects’.

The letter also said that there are ‘specific safeguards in place’ which prioritise patient safety and continuity of care.

Patients with evidence of recent NHS activity, such as an active prescription or recent hospital visit, are ‘excluded’ before progressing through the process.

Dr Doyle added: ‘NHS England currently applies a minimum 18-month activity check using available data as part of these arrangements, helping to ensure that patients actively accessing NHS services are not inappropriately identified.

‘Where a patient is identified as potentially no longer resident in England, they are contacted and given multiple opportunities to confirm or update their details. Contact may take place through a combination of letter, email and SMS, depending on the information available.

‘Patients can respond through a number of routes and are given sufficient time to do so before any further steps are taken. All validation checks and attempts to contact the patient are completed before an FP69 is set, and the establish process is initiated.’

The BMA’s GP committee recently demanded ‘urgent discussions’ with the Government over the list-cleansing drive.