An NHS England policy designed to remove inactive “ghost patients” from general practitioner lists has come under scrutiny for inadvertently removing at-risk individuals from healthcare access, particularly in deprived communities. The policy, introduced last October, reduced the timeframe for inactive patients to respond to outreach efforts from six months to three months. Analysis by Healthtech-1 found that registered GP lists in English practices declined by 483,019 patients between October 2025 and July 2026, with practices in the most deprived fifth of the country accounting for approximately 138,400 of those removals.
GPs and practice managers have reported significant operational challenges stemming from the accelerated timeline. A Southampton university practice physician noted that patients were being incorrectly removed from lists, causing them to lose access to repeat prescriptions and ongoing treatment. The practice reported approximately 100 erroneous removals, resulting in around £10,000 in lost income. The GP highlighted concerns that reducing the response window from six to three months would inevitably result in more people being removed and facing treatment disruptions, particularly affecting vulnerable populations.
The policy changes have created financial strain on practices while generating administrative burdens as staff must re-register vulnerable and elderly patients who were incorrectly removed. Since practice income depends on registered patient numbers, list reductions have left some practices struggling with operational costs. Dr. Clare Bannon, chair of the British Medical Association’s GP committee, stated that while GPs support maintaining accurate patient lists, the current process is “seriously flawed” and called for a pause to the exercise.
NHS England defended the policy, stating that robust checks exist to protect vulnerable groups and that people are contacted through multiple channels with processes lasting up to five months before removal. An NHS spokesperson said the process ensures accurate contact information for screening and vaccination communications while allocating funding fairly.
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