Patients being unfairly struck off GP lists, Ombudsman report warns

GP practices are removing patients in “inconsistent and often incorrect ways” – with some being struck off for making complaints about the practice, a new report has shown.

The Northern Ireland Public Service Ombudsman (NIPSO) has raised concerns in a report that shows many practices appear to be unaware of, or are misinterpreting, the regulations governing patient “de-registration”.

An analysis of investigations carried out by the Ombudsman found that patients were sometimes removed unfairly, without any apparent consideration of legal requirements or professional guidance.

In some cases, it appeared that patients were removed without first receiving a warning or being provided with an opportunity to discuss the concerns about their behaviour.

Some patients were removed simply because they had made a complaint about the practice, while some practices have removed entire families or households based on a single disagreement with one individual.

The report emphasises the right of patients to express dissatisfaction with their care without the fear of being de-registered.

Ombudsman Margaret Kelly has called for more guidance to GPs to make sure they understand that their own policies, including “zero tolerance” procedures, do not override statutory legal obligations.

She also wants greater clarity around when a patient/practice relationship may justifiably be considered to have irrevocably broken down, and an independent review mechanism to provide assurance to both parties that a removal decision was fair and impartial.

Ms Kelly said the removal of patients from GP practice lists can have “a very significant impact on access to health services”.

“It is important the removal of patients should only occur as a last resort and in line with the law,” she said.

“Current evidence suggests that more guidance is required to ensure that GPs fully understand their obligations before they take the significant step of removing patients from their practice.

“I believe this report highlights some of the misunderstanding in this area and hope it goes some way to improving how the system operates for the benefit of both patients and staff.”