AIBU to think this GP list validation is OTT?

[MsGreying]

The GP Practice have sent out a message via the app (biometrically connected to me) to make sure that I am a person and not a ghost.

https://quaysidemedicalpractice.co.uk/ghost

What’s happening?
The NHS is reviewing GP registers to remove people who have moved away or can no longer be contacted. It’s a routine process called list validation (sometimes called “list cleansing”).

The problem: it’s moving quickly, and patients who still live locally and still want to be registered are sometimes being removed — often simply because they didn’t reply to a letter they thought was junk.

Optics: You've died, you might not be a ghost cos most people don't believe in them. Does the NHS believe in Ghosts?

Anyone with issues leading to them being unable to manage their own affairs may well fall foul of this and be unlisted!

Sending out 68M plus letters sounds like an interesting challenge for any organisation.

This feels insane. Who thought this up?

They have to do something, people do move away without saying, or die, or switch doctors.
I am sure this wasn't an easy thing to do, so they probably looked at other options first.
No system is perfect, but something has to be done.
If a dr stops taking new patients because they mistakenly think they have a full load, someone else misses out.

It says if you think you may have been removed in error, to get in touch 🤷‍♂️

It's a common phrase for outdated entries on a list. It isn't a term that's only used by the NHS and it certainly doesn't imply that they believe in ghosts! FFS."This feels insane" is a massive overreaction, they're just trying to clean up their lists. Can't to right for doing wrong with some people.

I doubt they'll be sending out 68M letters, either. They'll send them out to people that they haven't had contact with for some number of years or who haven't replied to screenings or where they have some other reason to believe that they might not still be in the area/want to be on the list etc. to check before they remove them.

There's so many better ways they could do this. If it's a real problem that they need to solve. Maybe transient unstable communities cause these issues; maybe the proliferation of HMO has a bad effect for not only communities but the NHS data.

They could:

1. Ask when you book an appointment by phone. Can't often as people fill forms in to get triaged for appointments.
2. Ask when you attend an appointment. Can't because logging in is automated unless the machine is broke, but the GP/PA/N/etc could confirm.
3. Ask when you order a prescription on the app. can't without twiddling with the app.
4. Ask on the app to confirm. Why didn't they build this in if it's a problem?

Using a letter or a text is a terrible idea - it's outside the 'environment' that people use. And is therefore a wide open to fraud and spam from this point onwards.

There's actually no address check on a text either.

If they say "contact us" if you've been removed, then chances are you'll find out when you try to contact the GP who you believed you were registered at.

A significant number of the "ghost entries" will be people who aren't booking appointments or using the app or having regular prescriptions so none of those methods of confirmation will work to remove the ghosts. If people have left the UK then there is no onward transfer of records so you could have a family who emigrated to Australia who won't have the NHS app, won't be ordering prescriptions, won't be attending appointment but are still registered with the GP and taking slots.
My ex partner moved to Manchester from Durham in 2000 but didn't ever register with a GP in Manchester until 2003 after he was discharged from hospital following a heart attack. He hadn't needed any GP appointments and wasn't on medication then

What will happen. The practice gets a list from the health board of patients they(the health board)think are no longer in the area so they shouldn't be paying for them. We had a list of 500 patients once. We had to go through every one of them to see if they were still registered and if they were we had to let the health board know this so they didn't remove them. If we got no reply then the health board would remove them very quickly so if you then came in for something after a couple of years the practice would not have you still registered. We did this pre computerisation so it was hard work.
If you were on repeat medication or coming in frequently then that's easy but the health boards don't take our word for it they need proof.

So it will be a list initiated by the health board/ authority which the practice then act on. Not done by the practice for fun.

My gp sends out a text via the nhs app if you have had no contact for 2 years. If no reply after 1 month then they send a letter to your registered address - I know this because my dd moved away and we received a letter (addressed to her) stating the above last week. I phoned the drs explained she lived overseas now and they said they would keep her on the books for when she returns here, which they didn’t have to do.

I don't really understand what you are proposing instead.
If someone didn't reply to a letter because they thought it was junk, then, surely, it is their responsibility.
If someone died, they should be removed from the list. GP is usually informed of their passing. Why would they need to be kept on the GP list? They no longer require medical care.
If someone is unable to manage their affairs, there will more often than not be other services involved who liaise with the GP.

I am certainly guilty of moving out of area and not registering with a new GP for months and, on one occasion, years. If I don't use the service, I have no problems with being removed. After all, it's easy enough to register again when I need them.

I've had this more than once, because it must be about 20 years since I actually needed to see a GP. But I do want to stay on their list, just in case. It makes sense for them to check that people like me are still 1) alive and 2) at the same address.

They could:

1. Ask when you book an appointment by phone. Can't often as people fill forms in to get triaged for appointments.
2. Ask when you attend an appointment. Can't because logging in is automated unless the machine is broke, but the GP/PA/N/etc could confirm.
3. Ask when you order a prescription on the app. can't without twiddling with the app.
4. Ask on the app to confirm. Why didn't they build this in if it's a problem?

The whole point is to find out what people are not using the service because they no longer need to be registered! By definiton, those that are turning up for appointments shouldn't be off the list. And if they've made an appointment, they haven't been removed. You've got this completely backwards.

Yes exactly this. It will be sent to people that have had no contact/appointments/prescription requests usually in the last 2 years but that may be practice dependent.

They are not looking to get rid of people that want to be registered but are fortunate enough to have not needed the service but there will be people no longer in the area etc or who have died and the GP's haven't been notified. It is necessary to ensure there are spaces on their caseload for babies being born and people moving areas etc.

Have you even thought this through?

At those points you will already be using the service.

I got a letter years ago to check if I still wanted to use the practice, because I hadn't used it for years.

“…often simply because they didn’t reply to a letter they thought was junk.”

If you, as a grown adult, ignore or throw letters away from your doctor’s surgery then the consequences are you’ll be taken off the list.

How much administrative molly coddling should taxpayers be expected to pay for? People should take responsibility.

I’ve just moved house. So far I’ve had letters for five different people. This includes checking if one person still wants to be registered with a local GP and one trying to confirm whether a different person still wants to be on the organ donation register (neither one opened BTW, the envelopes gave me enough info to find out). So that’s at least one person who hasn’t deregistered, so at least one less space for people who still live here.

There is a point that some people move a relatively small distance, but wish to stay registered at a GP they are now out of area for (maybe for continued care reasons), so they don't update their address and consequently miss out on routine screening and vaccination programs, or don't get results of tests - eventually my GP puts the result of my glaucoma screening on the nhs app, but the consultant who does the screening writes to me and my GP. The GP assumes that I will have received the letter and if necessary arranged the required treatment.

Honestly working in the health service (childrens) it's bloody frustrating

Phone to book and appointment - no answer
Send letter for appointment - they don't show
Call to get hold of then - no answer
As per policy have to offer 2nd appointment- repeat steps above
Second time they don't turn up
Contact GP surgery asking if they have had any recent contact
Finally get a response they haven't seem then since they registered and even then it was just a form
Contact safeguarding see if any concerns from other agencies
Send text and or to client asking them to confirm Contact details - no answer
Gp through whole thing again for next mandated Contact
Finally GP has their own system that de registers them child health asks us to confirm address
Phone client yet again no bloody answer
2yrs later they movement in Contact they left the country and are back again

Smash head on wall
Personally I think everyone should have to re register every 6months

@Somersetbaker, I see your point, but my house is an ex student rental, so I’m fairly confident the people have moved away.

How else did you think Starmer and Streeting got waiting lists down - they stated with hospitals, and now it’s GPs ;)

Drs are notified if you die though? I had a phone call from my dads drs discussing his death and walking me through next steps

Not unless they know the deceased persons registered GP.

We’ve had notifications of deaths months after the event, once coroner’s officers or the police have identified the deceased, and discovered what surgery they were registered with. Many people don’t use their GP practice much if at all, and if no local next of kin to advise us then we wouldn’t know.

When DMIL died, we were told that we would need to notify her GP practice ourselves. I am not sure what they did with the information we gave them, because three weeks later, we had a phone call from social services wanting to do an assessment, the one we had needed for years, but couldn't get because she was self funding.

As far as I know, social services don't have access to GP records to see that the patient is no longer alive. And GP doesn't have access to SS systems so wouldn't know the person was waiting for an assessment.

It's a sign of the times. Our GP surgery knew my grandparents, parents etc...The GP gave us recommendations on where to visit in Edinburgh and Glasgow and asked us to bring back haggis from a particular butcher.

I don't know any of the GPs in the same surgery now and haven't been since around 2017. I was prescribed antibiotics over the phone for a UTI in 2020. I took my daughter in 2024 and saw some sort of assistant so didn't get to meet any of the new GPs then.

Because I don't know anyone I'm even less likely to go and more likely to muddle along for longer. I received one of those letters recently.

I live in a student-heavy area. I doubt most of the graduating students notify their GP that they are leaving. The GP won't know which ones are staying on for a further year, which are registering back at their home/new location for good vs just temporary, which have gone overseas, etc. There are other sources of medical/first aid/mental health care available, so some of the students may never have seen their GP or used the practice services. They'll need some way of confirming whether to keep them on the books, especially as a whole new cohort of students will be arriving in a month's time.

(on a side note, I wonder if the doctors there are interested in continuity of care or long term conditions for the patients who have been around for decades, as they must be a pretty small proportion of the patients, and maybe it's a low priority for the practice generally. And the variety of conditions the GPs must be expert in might be different too, given that there are relatively few children, menopausal women, elderly etc. Maybe it explains why I can sometimes feel like an annoyance, having to come back to try to get follow-ups for things - if they're used to being able to pass someone on after 3 years)