GPs are resisting NHS request to update their patient lists

GPs have resisted calls to update their patient lists after suggestions practices may be including dead people and getting more cash.  

The health service has restarted its investigations into so-called ‘ghost patients’ after they were paused to allow GPs to cope with the increased workload of Covid.

It comes after MailOnline last month revealed more than 5.2million patients who do not exist are registered at GP surgeries in England. 

Surgeries are paid roughly £150 per year for every individual on their books, regardless of whether they see them. 

NHS England has now asked outsourcing firm Capita to restart its checks to ensure practices are not being given money for patients who have died or are registered elsewhere.

But the British Medical Association (BMA) — which represents around 160,000 doctors — has hit back at the requests to update the lists.

The union said it is ‘a bureaucratic burden’ that ‘will detract from practices’ and doctors ability to provide care. Its request to delay checks has been rejected.

The notional cost of ‘ghost patients’ — many of whom have either died, moved abroad or are duplicates — is in the region of £750million a year. 

Patients’ rights campaigners suggested that practices could be deliberately letting their patient lists become overinflated to get extra cash.

Primary Care Support England (PCSE), an administrative arm of Capita, emailed every GP in England earlier this month announcing it was restarting its checks on lists.

The email said: ‘NHS England has asked PCSE to recommence data quality checks on GP practice patient lists, this includes a reconciliation of your practice’s patient list.

‘This work was paused intermittently during the Covid-19 pandemic but has started again on Monday, August 1, 2022 and this will be a phased approach over the next 12 months.’

It said data quality checks ‘are carried out to reduce the number of patients incorrectly registered with GP practices’. 

The email adds: ‘Accurate patient lists help to deliver safe patient care by ensuring patients are correctly registered for services.’

It added accurate lists will ensure ‘that practices are paid correctly for the number of patients they have’.

Practices will be approached individually by PCSE and have to give them a detailed patient list within 30 days.

The service will then check these for ‘discrepancies’ over 14 days, before contacting the practices again, who will then have to fix them.

PCSE will look specifically for discrepancies with patients aged over 100, those that migrated to England a year ago and students. 

But the BMA has asked NHS England to delay the checks ‘until practices had their full complement of clinical and administrative workforce’.

In a newsletter to GPs, the union said: ‘We have raised our concern with NHSE/I that this is a bureaucratic burden for practices which will detract from practices’ capacity to provide patient care. 

‘We asked that the process be delayed until practices had their full complement of clinical and administrative workforce.

‘Whilst NHSE/I have acknowledged and considered the points raised, they have declined our request, stating that the process will only affect a small proportion of practices nationally and that there will never be an ideal time to restart the process.’

Ghost patients have been a scourge of the health service for decades, warranting front page headlines and even an investigation from the NHS’s own fraud team. 

Authorities brought in Capita to stamp down on the issue in 2015 — when there were roughly 3m ghost patients — but it has since got even worse. 

The firm was contracted to vet GP lists and remove patients who could no longer attend the practice. 

But its work was put on hold until 2018 because of budget cuts. Its annual cleansing was switched to every three years instead. 

In the coming checks, it will also go through patients aged 16 recorded as living alone, and those living in demolished properties, to see if they should still be on lists.

The NHS Counter Fraud Authority revealed it was conducting a data analysis exercise into losses being made because of GPs claiming for non-existing patients in June 2019.

The Royal College of GPs (RCGP) and the British Medical Association have dismissed any suggestions of fraud. 

Professor Helen Stokes-Lampard, then-chair of the RCGP, branded the probe ‘shocking’ and insisted the issue was ‘nothing sinister’.

Studies have shown a third of ghost patients are duplications, like students registered in two areas at once. 

Others can be patients who have died and not deregistered as well as children who split their time between their parents.

Fraud investigators claimed in 2019 they had noticed suspicious anomalies when they opened the formal probe. 

They believed a small number of GPs deliberately kept names on their lists, but most were simply failing to prioritise the issues.

The RCGP argued that ghost patients were merely a result of record management issues, saying that staff have too much work on their plates and need better IT systems to address ghost patients quicker. 

MailOnline was told the fraud investigation was halted early last year, in part due to pressures caused by the Covid pandemic. 

The NHS is not considering reopening the investigation — although this could change if its ‘intelligence picture or priorities shift’.

The NHSCFA estimates GP fraud, which includes creating fake patients or deliberately keeping dead ones on lists, actually leaves the health service vulnerable to losing £93.8million every year.