'List Cleansing' at YOUR GP Practice

[The Gardens Surgery]

The Local Authority has decided to make sure that patients registered at GP Practices really do live at the addresses on their records. From late Summer, they will be pulling details from GP Practice records and sending letters to any patient who has not had an appointment for the last 2 years. If you do not respond within their time limit they will remove you from your GPs list. This is not done by your practice but by the Health Authority and your Practice has no choice.

If you have not seen your GP for the last 2 years, we at the Gardens Surgery (we cannot speak for any other practice!!) would welcome you coming to say hello to a GP or a nurse so we can check you over. We don't want the first you hear of this to be when you're unwell and you call us to find you've been removed.

The Gardens Surgery Team

[monniemae]

It wasn't the Health authority who booted me off with no warning when I moved temporarily .02 miles outside of the catchment while we had work done to our house though, was it? It was you guys. And you then cheerfully enrolled my partner, who was living with me, at the same address.

[Gidget]

But if you respond then everything will be A OK won't it?

[davidh]

surely patients not coming in is good, means they are well which is supposed to be the idea

[Mamma Mia]

How will they find time to see all the fit and healthy patients? It can take a week to get an appointment when you are ill.

[first mate]

First question, just how do they get to 'pull' details from patient records? Will they have access to full records or simply a list of names and addresses supplied by you? I feel deeply uncomfortable with the idea of any LA personnel being able to 'pull' stuff off my records- just on principle!

[LuLu Too]

OP - please can you be clear about your terminology; you refer to both "the local authority" and the "health authority". I assume you actually mean the PCT (Primary Care Trust) rather than either LA or HA?

And as these are about to be abolished in less than a year, this "list cleansing" exercise is, I assume, on behalf of the GP's who will come to form and lead Southwarks future Clinical Commissioning Group?

[Huguenot]

Just to alleviate some confusion, I believe this to be to do with how GPs are funded.

I should make clear before I explain that this is not a criticism of GPs in general or The Gardens who looked after me very well when I was in ED. In brief:

"At least half of practice income comes from a global sum that is based on the number of patients within a practice, weighted according to their age profile, gender, levels of deprivation and ill health. Adjustments are even made to reflect the costs of recruiting staff in each locality." (source: British Medical Association)

GPs have come under fire for counting patients based on outdated data regarding patients who have left the area or changed doctors, and are hence double counted: meaning GPs are overpaid and your taxes are wasted.

Nobody (either the LA or the HA or PCT) is pulling details from patients records, nobody is going to the newspaper about anybody's STDs or telling your parter you cheated on them or chatting over the garden fence about your poo problems.

All that's taking place is that GPs are being asked to update their records regarding the total number of patients they look after and the general health of the population.

If they can't provide this information then they won't receive payment.

What The Gardens is trying to do is take very reasonable steps to ensure that it knows how many active patients it has, and what their level of health is.

Those patients who have not visited recently, and do not respond to update their local status and use of the surgery will be excluded from the payment calculation.

Now PLEASE calm down.

[Lowlander]

I had seven (seven) letters arrive the other week from a local surgery addressed to various people who've lived at my address in the past. I returned them all to sender as addressee not known.

If this was part of that excercise then good. As long as they get a reasonable amount of time to respond (28 days) and preferably a reminder in case the first letter is lost in the post.

[PeckhamRose]

I wrote to the practice manager of my surgery about this and here are edited parts of her reply.

" ... it is a national directive. Perhaps patients can raise their concerns through their MP or local PALS team.

The data the Health Authority pulls will not be clinical, just statistical.

The aim is to make sure GP practices only get paid for real patients."

[first mate]

If others recall, there were moves in the last year or so to widen access to patient records. I am not trying to muddy the waters, I just want to be clear as to exactly how this 'statistical' information is gleaned?

[The Gardens Surgery]

http://www.selondon.nhs.uk/documents/165.pdf

Apologies for not being more accurate. Although we often still refer to the 'Health Authority' The correct name is 'NHS SELondon'. It is this organisation who is carrying out the work on our list.

The above link relates to your Medical Record and the questions asked should be answered in the section 'How is my record used to help the NHS'

[first mate]

Is this to do with the summary health care records and what if you had opted out of those. I'm still no clearer exactly how relevant/what information is taken from the pateint records. Presumably practice staff do not have time to do this, so who would physically be putting info together and how? Is nature of info, name, age/DB , gender, address and whether surgery used in last year, or will more information be taken for 'statistical' purposes at same time?

[The Gardens Surgery]

http://www.selondon.nhs.uk/a/161

It is unrelated to the Summary Health Record.

Please see the above link with more information and contact details of the Information Governance Manager at NHS London who will be able to answer specific questions such as this.

[first mate]

Will do. This was not meant to be a criticism of you just a question about the process.

I have looked at the links and the information available online and it seems to me to be incredibly vague and loose. We are told that only necessary information will be taken, but not what that is. It is also implied that only people that need to know will have access to the information- again pretty vague. Oh well,one for Information Governance then.

[Penguin68]

Most practices have an electronic database of patients. That database can be searched to throw up all patient records which haven't been changed (perhaps accessed) for 2 years - i.e. nothing written in to them by doctors/ practice nurses etc.. I assume that this list of innactive database records can then be checked against the manual records to look for any manual (but not electronic) data entry. Patients with records which have had no amendments for 2 years are then written to to confirm they are still at their listed addresses/ registered with the practice.

The search can simply be on activity (unspecified) - which means that searchers at least initially only need very top level access to databases to sort and filter. They normally wouldn't need to see specific records, just access dates for those records.

Back in the day when I was a younger penguin I could go several years without bothering a doctor, so there must have been occasions when I was 2 years and more without record update - nowadays this is no longer so (anno domini). But in those days records were all manually recorded and kept in those brown envelope files. Much more difficult to run a search on.

[Pugwash]

I hope when they finish their 'cleansing' that there is a link to the hospital records. Working at Kings and Lewisham

Hospitals. we frequently have patient's GPs listed on their records and at least half of them show the wrong practice. Either the patient has moved and still using a GP outside the normal catchment area ( ie. move from Lambeth to Southwark and still showing a lambeth GP miles away from their new address) or surgeries have closed/merged etc. A real nightmare when trying to link up a district nurse referral.Hospital staff do not routinely check up that the correct GP surgery is listed on the notes

[Huguenot]

Pugwash, NO. I love you dearly but this is nothing to do with clinical practice, and everything to do with getting paid. That doesn't make it bad. It's just a process.

First mate, likewise? THEY ARE JUST COUNTING. Sorry for shouting, but nobody in any establishment cares about anything else regarding this particular process. The NHS isn't filled with people who care about your haemorrhoids or your unwillingness to share them. You are a banal and uninspiring number. Stop pursuing this please!

BTW Have you had that itch checked out? It niffs a bit.

[first mate]

Now, now Hugo, no need to get personal. You leave my haemorrhoids alone. Sooooo cruel to play on my paranoia too!:)

[simonethebeaver]

The Kings record thing is a nightmare. Mine has the practice I moved from five years ago still. Through my pregnancy I changed it every time I could. It even sat there on the print outs produced by my midwives, who were based at my current surgery! Months later, I was referred to a specialist and there, on my notes, from a clinic I had alerted to the error, was my old GP. I give up.