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NHSE restarting GP list cleansing despite BMA concerns on bureaucracy

by Costanza Potter
18 August 2022

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NHS England has asked Capita to restart GP patient list cleansing, despite concerns raised by the BMA that it is a ‘bureaucratic burden’ for practices.

In January, NHS England instructed Primary Care Support England (PCSE) – which is run by Capita – to temporarily stop issuing requests for GPs to validate its list cleansing activities to free up practices for clinical work.

But the process to hunt for ‘ghost patients’ – which ensures patients who have died or registered elsewhere are no longer counted towards a GP practice’s funding – was restarted on 1 August and will see a third of GP practices contacted each year. 

The BMA said it raised concerns with NHS England that this is ‘a bureaucratic burden’ that ‘will detract from practices’ capacity to provide patient care’ and asked for the process to be ‘delayed’.

However, it added that NHS England has declined this request.

An email sent to practices by PCSE said it had been asked by NHS England to ‘recommence data quality checks on GP practice patient lists’ – including list ‘reconciliation’ – to reduce the number of patients incorrectly registered with GP practices.

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

‘Accurate patient lists help to deliver safe patient care by ensuring patients are correctly registered for services including access to relevant screening and vaccination programmes, and that practices are paid correctly for the number of patients they have.’

The email added that practices will have 30 days to send PCSE the patient list linked to their clinical system after receiving a request to do so.

After a process of ‘up to 14 days’ to ‘check for any data discrepancies’, practices will be sent a list of actions that they must also complete within 30 days, it said.

However, PCSE said it advises these are ‘undertaken as soon as possible and ideally within 10 days of receipt to avoid any new date issues’.

‘It is the responsibility of each practice to maintain its patient list’, it added.

In January, NHS England said it would remind PCSE that GP practices have a contractual right to be given a 30-day deadline to validate list cleansing requests, after some practices were given five-day deadlines.

separate email sent to practices added that PCSE’s ‘annual rolling programme’ will also target the following ‘areas of greatest [list] inflation’:

  • Patients aged over 100
  • Patients that migrated to England 12 months ago (Transient)
  • Patients registered at an educational facility for four or more years (Students)
  • Properties the Royal Mail report as demolished (Demolished Properties)
  • Properties with eight or more registered inhabitants (Multiple Occupancy)

PCSE said it will compile lists for each group and send these to either the practice or a letter to the patient directly requesting that the registration details are confirmed.

It will then either add a note to the patient record confirming the details are correct, process the patient ‘deduction’ from the practice list or apply a marker so that the patient will be ‘deducted’ in six months’ time unless an update or new registration is received or the patient is under 18.

PCSE advised practices to ‘check their clinical system regularly’ to avoid flags building up and to use the six-month window provided in the contract to avoid any incorrect patient deductions.

‘Having to re-register a patient means the loss of capitation for at least one quarter’, it warned.

According to the BMA, PCSE’s plans to start a new 12-month cycle mean that ‘a third of practices will be contacted over the next 12 months that have not previously had a reconciliation request’.

In its latest email bulletin, the BMA’s GP Committee 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.’

It added: ‘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.’

A version of this article first appeared in our sister title Pulse