The number of patients who may not exist but are registered with GP surgeries in England has increased by almost two thirds since 2018, potentially losing the NHS close to £1 billion, after an investigation into possible fraud was shelved.
The term “ghost patients” is used to refer to the gap between the number of patients registered with GPs and the number of people in the general population.
NHS Digital figures analysed by the PA news agency show there were 62.9 million patients registered with a GP practice in England in November last year, compared to the Office for National Statistics (ONS) estimate of 57.1 million people in England in 2022.
Assuming the population figure given by the ONS is correct, this equates to around 5.8 million ghost patients being registered with surgeries—61 percent higher than in 2018, when NHS data suggests there were around 3.6 million ghost patients.
Practices are paid for each patient on their books, with GPs receiving £164.64 per person in 2022-2023, meaning they could have received up to £955 million that year for patients who do not exist.
In 2019, the NHS Counter Fraud Authority began formally investigating whether GPs were claiming for non-existent patients, but this investigation was halted due to the response to COVID-19 and has not been reopened.
The Taxpayers’ Alliance, which has long campaigned against the wasting of NHS resources, called for lists to be amended if unknown names cannot be located.
Tom Ryan, a researcher for the TaxPayers’ Alliance, said: “When it comes to GP patients, the numbers simply don’t add up. Taxpayers are subsiding service users who may not even exist.
“Unless these missing patients can be found, funding for GP practices should be amended accordingly.”
The Royal College of GPs refuted any suggestion that surgeries are deliberately profiting by keeping more patients on their lists than are genuinely registered.
Dr. Victoria Tzortziou-Brown, vice chairwoman of the Royal College of GPs, said it was important not to remove patients from lists simply because they may not have visited their doctor in years.
“GP practices try hard to keep their patient lists as up to date as possible, but this relies on timely and accurate information about the movement of patients so that individuals are not inappropriately removed from a GP list.
“So-called ‘ghost patients’ are nothing sinister, and are not a case of surgeries deliberately profiting by keeping patients on their lists when they shouldn’t be there—they are a records management issue.”
She said the discrepancy between the estimated size of the local population and the number of people registered at GP practices can happen for a number of reasons, and that as well as “list inflation”, there can be issues with under-registration—such as babies not being recorded as patients.
“People’s circumstances, and therefore our records, change all the time.
“Some practices, particularly in inner-city areas, have quite a high turnover. Our administrative staff spend a lot of time processing patients’ notes when we are informed that they have died, left the surgery or moved elsewhere.”
NHS England said in a statement that it works with GP surgeries to review and update their patient lists, “and it is vital that practices do this on a regular basis, so they are as accurate as possible.”
A spokeswoman for the NHS Counter Fraud Authority said, “The NHSCFA had planned to undertake an intelligence assessment on the nature and scale of GP capitation fraud in 2019.
“This was to improve our understanding of the risk posed to the NHS by fraud and error in general practice, primarily as regards GP capitation (this is the fixed amount of money that is paid to GPs for every registered patient).
“It was effectively halted by difficulties in obtaining core data and our priorities shifted from this position with the NHS response to Covid 19.
“We have not yet revisited the issue as we direct our resources to where the intelligence indicates the most appropriate priorities sit.”
