Once again, general practice has been in the spotlight for all the wrong reasons. The NHS Counter Fraud Squad are investigating general practice ‘ghost patients' in response to a statement from Labour MP for Birmingham Hall Green, Roger Godsiff. Mr Godsiff asked what action was being taken to ‘tackle the alleged practice of GP surgeries receiving payments for so-called ‘ghost patients' still registered at that GP practice but who have died or moved away’ (Bostock, 2019). The number of ghost patients has risen sharply, which is evident since the provision of primary care support services were outsourced to a private company, Capita, in 2015. This identification occurred through the list-cleansing process since the takeover.
It is obvious that practices are not inflating their patient lists artificially. Patients are added when they register at the practice, and removed when they move out of the area or if they have left the country. However, anecdotal reports have seen patients having to re-register at their own practices because they have been identified as ghost patients. I am sure, as conscientious GPNs, if we had concerns about ghost patients we would inform our practice managers.
In other news, Jane Chiodini, general practice nursing's ‘travel guru’, has kindly shared with us information on the updated clinical negligence scheme. You may remember that NHS resolutions stated in May 2019 that the Clinical Negligence Scheme for General Practice (CNSGP) covered general practice for private travel vaccines. However, a new document was issued 12 June 2019 that overturned previous advice (NHS Resolutions, 2019). It stated that ‘travel vaccinations and immunisations for which patients have to pay a charge are not NHS services and therefore not covered under CNSGP’ (Chiodini, 2019). NHS England has clarified that while General Medical Services and Personal Medical Services contracts allow GP practices to administer and charge for certain vaccinations, when the patient pays for the vaccine or immunisation, they are considered private health services and not NHS services. It was previously understood by the Department of Health and Social Care that these services were included in part 4 of the General Medical Services contract as an additional service, and regarded as solely primary medical services.
Therefore, as from now, you are not covered if you give private travel vaccinations, or immunisations and possibly even if you discuss malaria chemoprophylaxis as well. It is vitally important for GPNs to ensure they have additional indemnity cover from providers, such as the Medical Defence Union and the Medical Protection Society. The Royal College of Nursing is looking into this and updates are sure to follow.
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