The Royal College of General Practitioners has responded to reports that the NHS Counter Fraud Authority has launched an investigation into 'ghost patients' on GP lists.
It says that the insinuation that GPs – some of the most trusted professionals in society - are complicit in defrauding the health service is shocking and will be incredibly hurtful for hard-working GPs and their teams who are struggling to deliver care to more than a million patients a day across the country, with insufficient time, resources or workforce to do so.
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "It is, of course, important to make sure that patient lists are kept as up-to-date as possible, so that resources are used where they are most needed – and our administrative staff already spend a lot of time processing patients' notes when we are informed that they have died, left the surgery or moved elsewhere.
"But so-called ‘ghost patients’ are nothing sinister - they are the result of a records management issue, not a case of surgeries deliberately profiting by keeping patients on their lists when they shouldn't be there.
"People's circumstances, and therefore, our records, change all the time. Some practices, particularly in inner-city areas, have quite a high rate of turnover, and patients don't always tell us if they are moving on. It’s just an inevitable consequence of having a list in the first place.
"It's also important that whilst we work to ensure patients who shouldn’t be on the list are ‘removed’, it’s equally important to make sure those who should be there are protected and not taken off without good reason, or before notifying them beforehand."
What is the cost of NHS fraud?
The NHS Counter Fraud Authority (NHSCFA) is a new special health authority charged with identifying, investigating and preventing fraud and other economic crime within the NHS and the wider health group.
According to its latest estimate, fraud costs the NHS £1.29 billion a year. It states that is enough money to pay for over 40,000 staff nurses or to purchase over 5,000 frontline ambulances.
It classes 'fraud', as a range of economic crimes, such as fraud, bribery and corruption or any other illegal acts committed by an individual or group of individuals to obtain a financial or professional gain.
Stokes-Lampard added: "We appreciate that it is NHS England's responsibility to review patient lists and put the appropriate measures in place to ensure that methods of doing this are safe. But to publicise that they are getting their in-house ‘fraud squad’ involved, as well as outsourcing the task to a company that many healthcare professionals across the country have little faith in to do a good and fair job, is demoralising for GPs and a questionable use of scant NHS resources."
NHS fraud priority areas for 2019/20
Each year the NHS Counter Fraud Authority (NHSCFA) sets a number of priority areas for action, based on its latest evaluation of available intelligence on the fraud risks facing the NHS. The NHSCFA’s strategic intelligence assessment based on data for the 2017-18 financial year forms the basis for its four priority action areas for 2019-20, which are:
- Pharmaceutical contractor fraud
- Procurement and commissioning fraud
- Fraud in relation to general practice contractors
- Improving fraud outcomes in the NHS
Susan Frith, Interim CEO of NHSCFA, said: "By setting clear goals based on the national intelligence picture of fraud risks and working with colleagues across the NHS to deliver them, we can make sure counter fraud work at both national and local level is focused on achieving measurable outcomes. In order to measure the impact of NHS counter fraud work we will use a set of financial targets, which for the first time this year include a measure of the value of prevented fraud."