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Ghost Patients: Cleansing the Patient Records that Haunt the NHS

If you haven’t been in contact with your GP in the past six months, you might be mistaken as a ghost. You could be one of the millions of ghost patient records that are haunting General Practitioners and the National Health Service of late.

Widely used to describe patients who have not visited their GP surgery within the last six months, ghost patients are a costly challenge to the NHS, as GPs are allocated £150 per patient record. What the NHS is discovering, however, is that many of these records belong to deceased or patients who have moved away – ghost patients.

As if this weren’t challenging enough, the NHS’s approach has created a costly and largely inaccurate patient database that appears to only be getting worse.

Does the NHS think you’re dead?

Despite a nationwide concentrated effort to decrease “ghost patients”, the number of ghost patient records is only growing. Recent figures show that the number of potential ghost patients was at a 10-year high of 3.1 million in 2017, a 43% increase from 2.2 million in 2007.

In the midst of these rising numbers, GPs warn that many of the scrubbed records are in fact legitimate patients who should never have been removed. Young children, elderly patients, disabled persons, or simply healthy people who haven’t had to contact their GP are removed as the NHS attempts to clean practice lists and squelch rising costs. Estimates figure that tens of thousands of genuine patients have been removed even after being flagged as validated.

In other words, the NHS may be incorrectly assuming you’re either dead or relocated.

Since 2015, the NHS has outsourced this list-cleaning endeavour to Capita, who requests GP’s send along a list annually of any patients who have not been in contact within the past five years.

Potential ghost patients are sent two notices in the mail: the first within ten working days and the next within six months. Those who fail to respond are removed from the GP’s list of active patients.

Aside from a cumbersome and expensive method of dealing with a seemingly straightforward problem, the NHS is now facing another issue: it’s not working.

How 4% Creates a Costly Problem

Why bother with such a costly and inefficient endeavour? In 2016 these ghost records accounted for only 4% of those listed with GPs, a percentage that at face value seems inconsequential.

The answer, as with most things, comes down to money. With a payout of about £150 per patient record and 1% of a GP’s budget, the NHS haemorrhages over about £550 million a year for patients who don’t exist.

Amid record numbers of so-called ghost patients, the NHS Counter Fraud Authority suspect many GPs are knowingly keeping outdated records on their lists in order to continue to receive larger payouts. The fraud team estimates as much as £88 million is being incorrectly claimed.

Considering a Better Way

While the cost-benefit is clear, the NHS’s attempt at a solution to the challenge seems as if it is making more work for themselves, especially when less manual and more accurate approaches exist.

Critics doubt the accuracy and cost-effectiveness of the NHS’s solution to a relatively straightforward problem. As Dr Maureen Baker, chairperson for the Royal College of GPs notably said in 2016: “It makes sense that lists are kept as accurate and up to date as possible – but methods for doing this must be properly risk-assessed, so that practices can be assured there are no patient safety implications.”

The NHS has obviously recognized the numerous benefits and importance of maintaining a list with the highest possible degree of accuracy, but failing to work with a data quality partner who understands proper list cleaning and maintenance has impeded, if not crippled, their efforts.

With the help of specialist list cleansing software and services, the NHS could avoid the need to write up to two letters to all these potential “ghosts”: they could effectively clean lists of deceased and goneaways and write to the new address for movers to check if they are now registered elsewhere. Readily available data from sources like Royal Mail, Equifax, and many more are already helping commercial organisations maintain updated databases and avoid regulatory and compliance fines.

With rising numbers of ghost patients and subsequent costs, it is confusing then why the NHS would continue conducting such an inefficient, inaccurate and laborious task.

The use of automatic suppression, change of address, and third-party deceased lists is well established across hundreds of industries across the UK and has been proven to save hundreds of millions in terms of revenue, productivity, operations, and customer experience.

In today’s digital age, the taxpayer is entitled to expect intelligent use of technology and data – and people who simply haven’t visited their GP for a while and still live within the catchment area are entitled to be kept on their doctor’s list!