NHS England to strike off ‘ghost patients’ from GP lists in bid to reduce costs
GPs working throughout England will be expected to provide a private firm with a ready-to-remove list of patients under a new cost-saving initiative unveiled by NHS England.
These so-called ‘ghost patients’- patients who have not attended their GP surgery for a period of five years - will be contacted at their last known address. If they do not respond within a specified period, they will then be sent a second letter. Should they fail to respond to this second and final letter, they will be removed as a registered patient, under a new scheme agreed by NHS England.
The scheme, expected to be rolled out across the country in the near future, is said to be an attempt to reduce payments made to GP practices in respect of patients who have passed away, moved elsewhere in the UK or even emigrated, but reports have previously emerged of people – including very elderly patients and children - being mistakenly removed from practice registers.
In a climate where people are increasingly left with no option but to live under short-term tenancy arrangements, which can make regular home moves a necessity, and other vulnerable people have been stripped of help with everyday tasks, concerns have been raised by the medical profession and campaigners that often vulnerable individuals could be inadvertently prevented from accessing GP services when they require them.
Genuine patients removed
Until now, decisions on how best to manage patient lists have been left to individual practices – and in some areas a similar approach is already in use. Previous GP list-cleansing approaches have resulted in thousands of genuine patients being removed, according to GP publication Pulse. Pulse has been reporting on the issue since plans were first announced by NHS England in 2013, when it was estimated that around 5% of patients were incorrectly registered. According to Pulse, the approach could “increase practices’ workload burdens” and result in a loss of funding – all while general practice faces mounting pressure.
The new system will be managed by private company Capita under a contract which, according to Pulse, states: “The supplier shall contact all GP practices in the eleventh month of every contract year requesting a list of patients who are recorded as not having had contact with the GP practice in the past five years.”
GPs are paid a set figure for each registered patient per annum – said to be in the region of £136 per patient - regardless of how infrequently they visit the surgery. An additional premium is then paid in relation to individual treatments provided.
Dr Richard Vautrey of the British Medical Association says he is concerned that patients will be unfairly penalised for being healthy. He says: "Patients should not be punished for being well. No-one knows, no matter how well they are, when they will need their GP.
"NHS England needs to think again about the potential negative impact on patient access and the additional implications for practices, who could find themselves in situations of conflict between understandably angry patients who blame the practice for removing them from their list, when the fault lies with wider NHS management systems."
“Serious impact on patient safety”
The Patients’ Association argues that some people may struggle to understand the letters from Capita or become confused as to why they were being asked to confirm details they had previously provided, while others could simply forget or be unable to respond without external assistance.
Katherine Murphy, the group’s chief executive, says: “If the NHS insists on proceeding with this plan, despite our previous warnings, then it needs to do so with extreme caution.
“People will wrongly be taken off the list and may not realise it until it is too late and they urgently need to see their GP.
“Moreover, when undertaking such a vast project like this, it is plausible that a patient could be removed in error. But taking the wrong person off the list could have a serious impact on patient safety.”
NHS England defended the move, saying that it is important to ensure patient lists are accurate and for “proper stewardship of public funds”.
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