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Wednesday 23rd April 2014
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Improving accuracy of GP lists saves NHS £6.1 million a year

23rd February 2012

Millions of pounds have been saved by removing ‘ghost patients’ from GP lists, following the Audit Commission’s latest National Duplicate Registration Initiative (NDRI) exercise.

Ninety-five thousand records were identified and removed following NDRI 2009/10, which looked for anomalies in patient lists across England and Wales. As each patient’s registration is worth £64.59 a year on average to their GP, these deleted records have saved £6.1 million in one year alone.

Andy McKeon, Managing Director of Health at the Audit Commission, said:

‘The NHS and GPs generally manage patient lists well – at any one time there are some 58 million records and many movements on and off lists. However, the NDRI, and active follow-up locally of duplicates and other anomalies, has resulted in £6.1 million annual savings. It is disappointing that some areas did not rigorously follow-up the information provided by NDRI, which would have resulted in more savings.’

The NDRI compares GPs’ patient lists with those of other GPs, and with other lists, to find ‘matches’. These identify a duplication or anomaly in the data, which can occur for a number of reasons, for example:

  • A patient has moved house and joined a new GP surgery but has not been removed from their previous GP’s list. In that case, both GPs would be paid for one patient’s care.
  • A patient remains on a GP’s list long after they have died.
  • A patient remains on a GP’s list despite also appearing on a list of people removed from the UK by the UK Border Agency.
Not every match will result in a removal, as local areas will carry out further checks to confirm the match is the result of a duplication or other issue. In some cases, for example, an apparent duplicate might actually be two different people with the same name and date of birth. The report highlights a number of areas that have rigorously and successfully followed up matches. In Manchester, for example, 200 patient registrations were removed following checks to confirm whether patients were still alive.

However, the report also says that in some areas, matches have not been followed up effectively, preventing records being removed and savings made. The report gives examples of good practice in following up NDRI matches and recommends that primary care trusts, and the organisations that carry out checks on their behalf, maximise the benefits of NDRI.

It is impossible to estimate how long ‘ghost patients’ would have remained on GP lists without these checks, but NDRI has identified a few extreme examples of patients who remained on GP lists despite having died many years before. NDRI 2009/10 resulted in the removal of 157 patients who had died before 1980, but whose GPs were still being paid for their care. One patient who died in 1969 was only removed from a GP list in April 2011.
The embargoed report is available at www.audit-commission.gov.uk/e-ndri.

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