The plan being developed in the east of England is intended to find out if people no longer require services, have moved house or have died
Patients who do not visit their GP for five years could be barred from their doctor’s surgery under plans being developed in the east of England.
Under the move, patients who have not seen their GP for five years will be sent two letters asking them to respond. If they do not get in touch to say they still wish to be registered with their GP, they will be removed from the GP practice list.
GPs are paid for every patient on their list – in 2013/14, the average GP practice received funding worth £136 for each registered patient. The drive by the NHS England regional team – known as list cleansing – is intended to cut costs to the NHS. The idea is to find out whether patients no longer require services or have moved house, left the country or died.
But critics have warned that “ghost patients” are being removed inappropriately as part of such drives.
Pulse magazine, which published details of the plan, has also carried out its own investigations that suggests thousands of “ghost patients” have been inappropriately removed from GP lists in recent years.
The NHS England East team sent a letter to groups of GPs known as local medical committees (LMCs) stating that people who had not seen their GP for five years “may be the people who no longer require services” and may be in “incredibly good health”.
It said list validation was necessary “to protect NHS money and ensure patient lists are not artificially inflated”.
But GP leaders said the move would increase their workload and could disproportionately affect some groups, such as adolescents.
Cambridgeshire LMCs said it had data that showed some groups, particularly children in early adolescence and men aged 20 to 45, could be disproportionately affected by the move.
In a letter to practices, Cambridgeshire LMCs said it was very concerned by the move “on grounds of discrimination, on grounds of workload, on grounds of making care for children and middle-aged men less accessible”.
The LMC added: “We note the true motive for this proposal from NHS England is, as they say, ‘to protect NHS money and ensure patient lists are not artificially inflated’.”
Cambridgeshire LMCs chief executive Dr Guy Watkins told Pulse that children aged eight to 15 would be affected “because they’re post routinely being seen, post most childhood illnesses, but actually they’re not being routinely brought by their parents”.
Dr Richard Vautrey, the British Medical Association’s GP committee deputy chairman, said: “Schemes like this just add to GP workload and irritate patients. Many patients understandably believe that this is something the practice has done to them and don’t realise that this has been carried out by NHS England.
“It therefore needlessly undermines the relationship between GP and patient. Patients should not be punished for being too healthy and being careful about how they use NHS services.”
Katherine Murphy, chief executive of the Patients Association, said: “It’s a slippery slope. Patients may receive the letter but not understand what they need to do.
“What mechanisms have they put in place to allow patients to respond to these letters given how difficult it is to get through to GPs?
“What if a patient has been in extremely good health, understands the pressures GPs are under and has deliberately not used the service? Will good patients be punished? I think patients will be unfairly discriminated against.”
In 2012, a report from the Audit Commission found that GPs had been paid for thousands of patients on their lists who had moved practice, died or been forced to leave the country. It identified more than 95,000 patients who needed removing from GP lists in England and Wales.
Ruth Derrett, locality director for NHS England East, said: “List validation is something which routinely takes place to ensure GP practices have the correct numbers of patients registered.
“NHS England in the east is currently looking at a validation process whereby patients who have not accessed their GP in five years are contacted. Under the process no patients will be removed from the GP’s list if they wish to stay registered with their GP.”
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