GP surgeries across England are removing so-called "ghost patients" from their lists in a national "cleansing" drive targeting six to seven million people, with patients urged to check their registration details. Around 830,000 patients have been removed over 10 months, including more than 315,000 in London — a third of the total — despite the capital accounting for under a fifth of England's registered patients.

How the list cleansing works

NHS England aims to purge patients who appear to have moved away or died. Private contractor Capita identifies targets based on a lack of prescription history or screening attendance, rather than how recently a patient has been in touch. Patients identified are sent a single postal letter giving them 30 days to respond; if they fail to reply, their record is marked with an FP69 flag. A rule change introduced in October 2025 cut the window surgeries have to track down patients from six months to three months. NHS England has now launched a pilot letting patients confirm they should stay on the list by texting "here" or "gone".

GPs warn of wrong removals

GP leaders warn the drive is wrongly removing legitimate patients. A survey by the LMC Support Network found almost 70% of practices had identified patients wrongly removed from their lists, and some practice managers have knocked on patients' doors to stop removals. Because list sizes feed into GP funding, practices say they are losing tens of thousands of pounds, with some warning they are at risk of going under. NHS England has pledged that money saved through the exercise will remain in general practice and be reinvested in core services in 2027/28.