This site is intended for health professionals only

GPs must check patient ID and proof of address to weed out ghost patients, says watchdog

GPs should be required to request identification and proof of address from all new patients as part of a drive to eliminate an estimated 2.5 million ghost patients from GP lists.

A major new report from the Audit Commission urges the government to strengthen patient registration procedures to prevent patient fraud and error following a massive list cleansing exercise across England and Wales which removed almost 95,000 ghost patients from GP lists.

The Audit Commission carried out the purge following its latest National Duplicate Registration Initiative in 2009/10 which revealed there were more than 30,000 dead patients on lists – including 157 who had died more than 30 years ago.

Almost 30,000 patients had moved house and were registered with two GPs, the Audit Commission found. A further 20,000 patients were removed from the lists when officials found they were not living at the address shown on the books.

The report backed an earlier recommendation from the NHS Counter Fraud Service that GPs ask to see a form of identification when registering all patients and a document containing the patient's address when registering permanent patients.

This would help prevent fraud and would also help address data capture issues in GP surgeries, the report said.

The call for GPs to police patient registration follows explicit instructions to NHS managers to target immigrants and elderly patients first in order to meet brutal new list cleansing targets next year.

As part of the urgent drive to reduce variance in population and practice lists by 3%, first revealed by Pulse in November last year, the advice from the Department of Health advisory body Primary Care Commissioning said PCTs should conduct ‘targeted campaigns' at certain groups to eliminate ghost patients.

The DH is ramping up its list cleansing activities because clinical commissioning groups will be set budgets based on their registered patient list populations - rather than the current system of PCT funding being dictated by national population estimates.

With the CCG management allowance set at £25 per head, 2.5m extra patients could see CCGs allocated an extra £62.5m in management budgets alone.

Andy McKeon, managing director of health at the Audit Commission, said: ‘The NHS and GPs generally manage patient lists well - at any one time there are some 58 million records and many movements on and off lists.

‘However, the NDRI and active follow-up locally of duplicates and other anomalies, has resulted in £6.1 million annual savings. It is disappointing that some areas did not rigorously follow-up the information provided by NDRI, which would have resulted in more savings."

The NHS Commissioning Board is set to take responsibility for list-cleansing once the Audit Commission is abolished.

Read the National Duplicate Registration Initiative 2009/2010 here