To ask how common it is to be removed off a gp lists

[thedaywewillremeber]

My friend has recently been removed off a gp’s list. She says it’s been because she had minor disagreement with a doctor at the practice. Aibu to think these more to as I’ve disagreed with doctors and this has never happened. Or could it really be that simple.

@BaylisAndHardon. We have 15000 but over 3 practices. I don't know the numbers for the other two so can only speak for the 1. I've also been on mat leave for 7 months so may have missed a few. Ours always get warnings then are offlisted if behaviour continues. We do the same with GPs not wanting to see a patient. We also get it the other way round where a patient won't see a particular GP. We also put a note on and don't book them in with that GP. I know of 2 in the year before I left. 1 never swore or shouting but consistently called reception staff stupid and spoke to us like dirt. The other was the abusive type.

It is not unheard of, but not common-place either. Most common reasons are abuse/aggression towards staff (any staff, not just the gp’s) or very frequent missing of appointments (and then removal is usually only after at least one written warning, which is only triggered by missing quite a few appointments). If a patient has a disagreement with a particular GP, then they can ask to see someone else- it does not require registering somewhere else.

Removals happen for many reasons e.g.when there are multiple appointments missed and at least 2 written warnings issued first. Or, a patient is making multiple complaints and GPs feel the relationship has broken down irretrievably - if a pt makes complains a lot there is usually a breakdown in trust and I wonder why a patient wants to stay where they are unhappy. Or the pt has on multiple occasions verbally abuses staff members either swearing, shouting, nastiness - at least 1 warning depending on severity. We removed a chap immediately without warning when advised he always carried a knife and was a risk to healthcare professionals.

There are people who are vile to reception team and then suddenly become meek and mild when they speak to a GP - total 180!

That said... I have heard of practices removing patients with very minor reasons if they simply found the pt hard work - this is unfair. MH pts need support.

"Minor disagreements" do not get you removed from GP lists, first strike, with no warning.

I suspect your friend is somewhat downplaying the situation.

If she thinks she's been unfairly removed she can contact the local CCG (or Health Board in Scotland, N Ireland or Wales) for a review as to whether the removal was fair, warranted or carried out correctly.

I personally know of one chap who'd been removed for a 'minor disagreement'. He'd punched the receptionist (not saying your friend has done this but there might be more to the story than she's telling).

Minor disagreements wouldn’t even cause a raised eyebrow in our practice. Even a bit of shouting only gets you a warning letter, ditto consistently late patients and repeated no shows.

The last person to be removed from our list was removed because he went apeshit after a prescription for drugs was refused. He showed his displeasure by kicking in the headlights of a couple of Drs cars!

I'm a social worker and regularly deal with people who can be quite difficult.

In over a decade the only people I've come across who have been delisted / removed from a GP practice have either repeatedly not turned up to appointments, have been verbally or physically aggressive towards practice staff (beyond what could be classed as a minor disagreement) or have persistently engaged in harassing or difficult behaviour and haven't complied with positive behaviour agreements.

Out of that list I know of 5 people ever to be removed In over 10 years, 3 of those were because of persistent non attendance.

@Blankblankblank

I reckon your place sounds like ours!

I don’t believe she would be abusive but think more that she’s someone that regularly complains about trivial things.

It happens all the time. Each area will have a service that takes people who no other GP will have ie because of violence etc.

Some GP's remove people from their lists more readily than others but it's rarely done for minor disagreements, its more likely she was extremely rude/verbally aggressive.

No not that rare. You don't necessarily have to have a massive falling out with the practice. What are you basing this on?

The BMA guidelines: www.bma.org.uk/advice-and-support/gp-practices/managing-your-practice-list/removing-patients-from-your-practice-list

If average surgery list size is 8750 people (says Google), and 8 of those get removed each year. That's less than 1/1000. I feel that 1/1000 chance each year should be classified as "rare". *

For medication side effects, 1/1000 may be described as "uncommon" rather than rare. We could confidently tell OP that this event is "uncommon."

*Why do MNers talk about things but never define what the words are supposed to mean.

Some GPs remove patients who have made complaints. Some even remove Family members of Those who have made a complaint.

GPs are within their rights to do so. They can remove a patient without giving detailed reasons, just as a patient can leave without giving a reason.

They can do this because they are not Usually NHS Employees , they are independent contractors.

When I worked at a GP surgery, you could get removed from the list for:

A) Being abusive/aggressive to a GP/nurse/receptionist, after previously receiving a written warning for the same behaviour

B) Being racist to a staff member (first time)

C) Sexually harassing/propositioning a staff member (first time)

It’s rare and a big deal imo, clearly the professional GP/Patient relationship is impaired

I also work in a surgery and it is really rare that we would remove a patient unless violence/abuse towards a staff member occurred - sadly some patients are removed when they are outside of the boundary and may need input at home.

VERY rare, I think you need to be an absolute arsehole these days to be removed.

BMA Guidance and they call it “rare”
The removal of a patient from a GP practice list should be a rare event. Reasons include:

disagreement between the practice and patient, and an irretrievable breakdown of the relationship
the patient has died
the patient has moved outside the practice area
patients have a right to change their practice.

Minor disagreement no.Telling a dr to go fuck himself yes.It would take a lot to get removed from a practice.Verbal aggression,physical threats etc imo.I worked in a drs for years and only knew of one that was taken off in all that time.

To be removed without warning at the ones I’ve worked in it has to be something pretty major - think threats / violence / police involvement, also we have a zero tolerance racism policy so could theoretically off list someone straight away for racist behaviour. As I understand it there’s quite tight regulations and practices can get in trouble for removing someone without good reason. I’ve been advised to record the crime number in case we are challenged for removing a patient - so we have evidence of police involvement if an assault.

@Dullardmullard that removal is likely to have been initiated by the health board who used to write to patients who hadn’t been seen for some time (or required GPs to write to them) and removed them from from lists if they didn’t reply, it was so they didn’t have to pay GPs to look after these patients!

It happened to me once in the mid 90's. I told my GP I wanted a home birth, she said I should go to the first appointment at the hospital anyway so I agreed to do this.

Hospital MW: Everything looks OK, would you like to see the consultant?

Me: Is there a particular reason to?

MW: No, everything looks OK.

Me: OK then, I won't take up his time.

GP then struck me off for 'refusing to see the consultant'.

I hope things have moved on since then but I suspect they haven't in some practices. It really could be something that simple for your friend and whether it is or not, it's none of your business anyway.

I have been delisted TWICE by mine (relisted again both times) simply because I haven’t been for years. I had no notification at all. And this despite the fact the test of my family were on the list and I visited with my children. ‘We thought you had moved as you haven’t been in’. Obviously didn’t occur to them to actually, you know, CHECK!

This was threatened to me because I was "aggressive" ie assertive about wanting to be seen when I had a raging ear infection. They kept saying I didn't have one, and wouldn't give me an appointment. It's unlikely in an adult, it will go by itself. I looked into leaving after this, but only practice in area and couldn't find a new one to take me.

BTW I did get seen and I did have an bad ear infection. Bastards.

I would say its rare, when my DS was 3 his GP refused to examine him despite the symptoms which were that he had pain and blood in his urine, he just gave antibiotics saying he couldnt take a sample (my son couldnt pass urine) and he would treat it like a urine infection. My son hadnt passed water for 23 hours by this time and I asked to see another GP, who saw him and examined him and he was rushed to hospital for an emergency operation. I was urged by 2 other GPs at the practice to take action against the first GP, which in the end I did and got a written apology, one of the other GPS asked if I wanted to take it further, but I didnt So a big disagreement but I wasnt removed from the surgery List