GPs claiming up to £88m for non-existent patients

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An investigation has begun by the NHS Counter Fraud Authority after it was found that in 2018 there were 3.6 million more patients registered to GPs than there were people in the country.

With GPs receiving an annual amount of £150 per patient registered to them, suspicions have arisen that some doctors may be claiming for patients that do not even exist.

It has been highlighted that there are other possible causes of such discrepancies– for example, many patients may move or die yet they are not de-registered from the appropriate GP list.

Despite this, investigators are suspicious that GP dishonesty may be contributing to the inconsistent figures.

During their research, the NHS group have been taking random samples of transactions carried out by GPs. From these, they have reportedly discovered several unexplained anomalies that have suggested fraudulent behaviour is to blame.

Action has been taken in order to make sure that all GP lists are up to date. This was done by collecting all of the data of those who have not been in touch with their doctor in the last five years.

These people were then contacted in order to determine whether they were correctly registered or not. Those who were uncontactable were removed from their respective GP list.

The final step of this investigation is to conduct an in depth analysis of all NHS England records. The records held by the NHS Business Services Authority will also be analysed, as they contain details of the payment systems used by GPs. By doing this, the NHS fraud group will discover the extent to which non-existent patients have been wrongly claimed for.

As of right now, it is suggested that incorrect claims are adding up to £88m. This is roughly 1% of the GP budget. With every bit of NHS funding being so crucial, the investigation into GP claims has been made a priority for the foreseeable future by the NHS Counter Fraud Authority.

Loveness Chihoyi, Trainee Legal Executive in the Medical Negligence team at Ashtons Legal comments: “It’s hugely worrying to think that the same GPs who play such a crucial role within the NHS may be acting dishonestly for their own personal gain. They, if anyone, will understand the consequences of increased financial strain on the NHS. There is a risk that with less funding being productively spent on GPs, the quality of care and resources they offer may decline. If so, it is likely that we may see a rise in the number of medical negligence cases against GPs. Hopefully, this investigation will prevent any non-existent patients being claimed for in the future, which should allow the NHS to utilise the entirety of the GP budget in the best way possible.”

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