'Ghost patients': how much are they costing the NHS?

23 September 2013

The head of NHS in England recently forecast that the health service would be facing a £30 billion shortfall by the end of the decade. As such, the message is that every pound and penny must be counted. With this in mind, the headlines that told of hundreds of millions of pounds being spent on so-called 'ghost patients' has suggested that there's still fat to trim.

Someone becomes a ghost patient if they're still registered with a GP after they've died or moved away from the area. The existence of these ghost patients isn't in doubt: there are more patients registered with GPs in England than there are people living in the country.

The source of the media's figures - on the number of ghost patients and their cost - is a written answer to a Parliamentary Question. According to official statistics, for each of the past five years there's evidence of more than two million ghost patients in England. (The Daily Mail refers to Great Britain, so we'll be asking the newspaper to correct its headline.)

To calculate the cost of these ghost patients, the newspapers have factored in how much a GP practice earns for every patient on its register. The newspapers have used the figure of £66.25. However, this is the price for 2013/14, not for the years concerned; every year the price increases in line with inflation. This means that the media is likely to have overestimated the cost of ghost patients.

The Daily Mail and Sunday Times have quoted £450 million as the cost of ghost patients since 2010, while the Daily Express and the Daily Mirror refer to £750 million as the sum total over the five year period.

GPs are not innumerate. As one of the government's health ministers observed, there are several reasons why the number of registered patients is higher than the total population. When patients die, their deaths are not immediately recorded. And for those people who emigrate, or who relocate to another part of the country, their previous practice do not necessarily delete their name immediately from the official register.

The point of controversy is the fact that there's a financial incentive for a GP practice to "conveniently forget" to remove a patient's name from their register. As the media have noted, several GPs have been accused of profiteering on this count. However, we haven't seen any evidence to suggest this tactic is widespread. 

The government has said that it is developing a national strategy for collecting this data. As we've noted previously, the Audit Commission has already conducted a study into the phenomenon. 

While earning money for a non-existent patient might not be the most effective use of NHS resources, it's possible that this money is still being invested in frontline patient care. If we're talking about a "waste" of taxpayers' money, there are clearer cut cases. The NHS National Programme for IT, which has now been shelved, is (according to official estimates) likely to cost the taxpayer in the region of £10 billion.


Flickr image courtesy of mareodomo

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