Exclusive LMC leaders have complained to NHS managers about the ‘disquiet and distress’ of a major drive last week to curb ‘list inflation’ that it claims targeted 700,000 patients in London.
Londonwide LMCs said that NHS England has sent 700,000 letters to patients last week asking them to confirm their address, in a ‘one-hit’ list cleansing drive it described as ‘genuinely regrettable’.
The LMC claimed the letters urged patients to open and respond to letters from the NHS confirming their address so they are not removed from a GP practice list, and continue to receive invitations to smear tests and immunisation letters.
The LMC said the ‘one-hit’ mailing was a ‘significant error’ that would divert GPs away from frontline care, would remove vulnerable patients from their GP lists and would cost more than the money NHS England would recoup from removing ghost patients from practice lists.
Dr Tony Grewal, medical director for Londonwide LMCs, said in previous years the LMC had an agreement called the ‘Once for London’ principles with the former PCT, which were largely upheld by NHS England until now. Under those principles in London rolling list-cleansing drives would be carried out rather than a mass mailing.
The agreement was made after one mass mailing saw NHS Brent suddenly wiping 38,000 patients from GP lists in 2011, in a move the LMC called ‘appalling’.
A Pulse investigation carried out earlier this year revealed that nationally, around 10% of patients removed as part of list cleansing drives were genuine patients as PCT managers scrambled to meet the Government’s target of removing 2.5m patients from GP lists by April 2013.
Dr Grewal said it was ‘regrettable’ that the London branch of NHS England had decided to carry out a list cleansing drive this way.
He said: ‘Unfortunately NHS England London told us they didn’t have the resources to carry out a rolling programme going through the alphabet. So they’ve sent out a one-hit mailing. 10% of patients will receive this letter as a matter of urgency.’
He added: ‘It’s a significant error. I have reflected to NHS England the disquiet and distress enforced by practices across London. These are practices that are not the usual suspects – they are working GPs who have been compelled to get in touch.’
Carrying out this kind of drive risks patient care, and will not produce tangible financial benefits, he said: ‘The danger with this is that it diverts GPs from other work, and the costs will not match any financial benefits in terms if reduced capitation.
‘Most of these patients will be genuine so these patients will be removed from lists. The patients that won’t open the letters will be the most vulnerable patients that we should be looking after the most; the elderly, those with mental illness or other social problems.
Many people will not open the letter at all, he said: ‘There are high non-delivery rates in London and lots of people will be away so they wont get the letter at all. Although they’ve used the Once for London principles in terms of the envelope and the NHS logo, everybody gets a lot of junk mail and they might not open it. I quite genuinely believe what they’ve done is regrettable.’
A spokesperson for NHS England (London) said: ‘The NHS England Tackling List Inflation 2013 Policy requires us to run a list maintenance programme. The policy acknowledges many of the points made in the Once for London agreement launched in 2011 and encourages a rolling programme of A-Z list maintenance over a locally agreed timescale.
‘However, it also allows for other cohorts of patients to be considered for list maintenance and for the approach to be agreed locally. The letters sent out last week were one such cohort and we discussed this with the local LMCs in advance. We echo the LMC in encouraging patients to always open letters from the NHS, not only because they may need to respond but because such letters sometimes include invitations to attend important routine screening.’