An NHS policy to remove “ghost patients” from GP lists is inadvertently leaving some of the poorest people in England without vital healthcare, analysis has found. Under previous NHS rules, inactive patients at risk of being removed from their GP practice were given six months to respond to outreach. But under NHS England’s accelerated list validation timeline, introduced last October, patients now have only three months to reply.
According to analysis by Healthtech-1, registered GP lists in English practices declined by 483,019 patients between October 2025 and July 2026, with the most deprived fifth of practices accounting for about 138,400 of the net decline – just under 30% of the national decline. While GP lists need reviewing as people move away or die, GPs have said the accelerated timeline has inadvertently led to patients from deprived areas being incorrectly removed, creating barriers to receiving treatment. Consequently, GPs and practice managers have reported having to re-register vulnerable and elderly patients, creating an additional administrative burden.
De-registering patients can also cause gaps in care and disruption to treatment. Since GP practices’ income also depend on the number of registered patients, a drop can leave practices struggling to pay for running costs. A GP at a university practice in Southampton said the accelerated timeline was causing problems because patients were being incorrectly removed from their list and were struggling to access their prescriptions and treatment.
That worked out as around £10,000 in lost income for our practice,” he said. We’re going to have to make cuts somehow to make up the shortfalls.” Dr Clare Bannon, the chair of the British Medical Association’s GP committee, said GPs across England support the principle of keeping patient lists accurate but the current list-cleansing process is “seriously flawed”. Bannon said: “We have called on NHS England to pause the exercise.
The approach is overly aggressive, leading to practices losing tens of thousands of pounds in income and causing active patients, including vulnerable individuals, to be removed in error.
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