According to Pulse, the Department of Health plans a national campaign to get rid of almost 2.5 million ‘ghost patients’ from GP lists across England.

In an effort to clean practice lists by April 2013, Ministers are calling for a nationwide prioritization of list validation, the time when clinical commissioning groups will be setting budgets based on their registered populations.

Politicians are alarmed that money could be handed over for non-existing patients by the move for budgets to be set by GP registrations instead of by the population estimates used for PCT funding.

The Commons public accounts committee received written evidence from the DoH that over 2.5 million more people than the country’s estimated population were registered with England’s GPs.

The DoH’s information that the Commons public accounts committee has been passed on to MPs, said that some possible reasons for the discrepancy included the period of time in which patients move between practices, however this was ‘insufficient to explain fully the difference of 2.5 million in the total number of GP registrations and the estimated population of England, and the proportionately greater disparities seen in some areas’.

The DoH announced plans for a three-tiered strategy to remove these additional patients from GP practices’ lists, in a ‘diagnostic exercise’ to remove PCTs, which ‘have still to carry out meaningful action’. This will allow the new NHS Commissioning Board to become directly responsible for ‘improving’ the clearance of the list, and linking its accuracy to ‘authorization’ of the new clinical commissioning groups.

Una O’Brien, DH permanent secretary, informed the committee:

“We are undertaking list cleansing; we started a significant initiative through SHAs last November and we are about to take that a step further in the expectations that will be placed on PCT clusters and emergent clinical commissioning groups to ensure that their registration lists are fully accurate and up to date.

Our intention is that the robustness and accuracy of lists is a factor that is included in the authorization of the clinical commission group so that there is actually a stop point where they have to demonstrate that their lists are sufficiently up to date and accurate to enable them to take on the budgetary responsibility.”

Pulse was informed by a DH spokesperson that:

“Our latest estimate is that there are 2.5 million more people registered with GPs than in the estimated ONS population for England. We are working to ensure PCTs give priority to updating GP lists prior to the NHS Commissioning Board taking on responsibility for commissioning primary care [in April 2013].”

However, GPs are voicing heavy concerns over the plans.

According to Dr Tony Grewal, medical director of several local London medical committees, and a GP in Hillingdon, North-west London:

“Vulnerable patients, migrants and multiple-occupancy addresses are among those adversely affected. Some practices are very, very seriously hit.”

Dr Richard Vautrey, deputy chair of the BMA’s GP committee, added:

“Practices will be very concerned about this and so should patients. In recent months we’ve heard numerous examples of patients who are angry they’ve been wrongly removed from their practice. It is right to ensure lists are accurate, but it must be done with care and sensitivity.”

Dr Martin Lindsay, a Haringey GP in North London, who lost 1,500 of his practice’s 11,500 patients in a list-cleansing exercise this year declared:

“We had three times the number of patients removed who should have been removed. This kind of thing harms patients and practices.”

The editor of Pulse, Richard Hoey commented:

“It’s obviously sensible to make sure the people on GP lists are actually supposed to be there, but it’s enormously difficult to remove large numbers of people from practices without catching quite a few genuine patients by mistake. Normally people will be asked to respond to a letter confirming they still need to be registered at a practice – but some groups, such as immigrants or students, are very bad at responding.”

Written by Petra Rattue