Are 2.5 million 'ghost' patients costing the NHS £162 million?

23 February 2012

"GPs make £162m out of 'ghost' patients: Anger over bill for 2.5m non-existent people"

Daily Mail, 23 February 2012

"The Department of Health admitted that although there are currently 55 million patients registered with GPs, there are only 52.5 million actually living in England. This means the NHS could be unnecessarily spending nearly £163?million a year."

Daily Telegraph, 23 February 2012

The Daily Mail and the Daily Telegraph both reported this morning that 'ghost' patients — patients who are still registered with GPs after they have moved away from the area or died — are costing the taxpayer £162 million.

Currently, funding for GPs is determined by the number of patients registered to the surgery, adjusted according to various factors such as age. However, surgeries can be slow to update records, so the Audit Commission ran the National Duplicate Registration Initiative to try to reduce duplicate and incorrect records.

Health Minister Lord Howe was reported by Sky News and the Evening Standard to have said that "although 52.5m people live in England, 55m people are registered with a GP".


The Office for National Statistics provides estimates of the number of people in the United Kingdom. Their latest figures for 2010 suggest that England currently has a population of 52.2 million.

Finding data on the number of people registered with a GP is slightly more complicated. While the NHS Information Centre provides figures for population registered with GPs, these figures are adjusted in accordance with the ONS figures for population, and so are not a true reflection of the number of registrations. They also do not give an indication of the number of excess registrations.

Full Fact contacted the NHS Information Centre, who provided us with data on the prevalence of diseases by surgery as part of the Quality and Outcomes Framework (QOF). As part of this, each surgery has listed the number of patients registered to it, totalling some 55,169,643 people. The Information Centre's most recent bulletin on the QOF suggests this figure is 99.7 per cent of all patients in England, which would put the final tally on the register at approximately 55,335,648, which is 3,101,648 people higher than the number of residents in the England.

The Commission's report also revealed that the average cost to the taxpayer per registered patient is £64.95. It seems that the Mail and Telegraph have used this to calculate the cost of 'ghost' patients. If we take the 55,335,648 estimate arrived at from the QOF data, we can put this cost at £201,452,038.

It appears that the difference between this figure and the one used in this morning's papers is one of rounding. The Mail and the Telegraph seem to have applied the cost per patient of £64.95 to the 2,500,000 'ghost' patients identified by Lord Howe), to arrive at a £162.4 million bill. However deriving the number of 'ghost' patients from first principles using the NHSIC data gives a slightly longer list, and hence a higher cost.

The calculations could also be affected by the rough nature of the average costs. The patients on the 'ghost' list may well be atypical by tending to fall into groups above or below the average.


The figures cited by Lord Howe seem to be confirmed by the ONS and NHS Information Centre, although the population of England is slightly smaller than he states, and the list of 'ghost' patients slightly longer.

The papers have calculated their estimates by multiplying the number of excess registrations by the average cost per patient, although using more accurate figures gives a slightly larger total cost.

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