Agenda item

Circulated to members in advance of the meeting was a briefing paper prepared by NHS Brent on the GP list validation exercise which was being conducted. There was a difference of over 100,000 between the census population and the registered list in NHS Brent and concern had been expressed that the validation exercise may not have been as fair and effective as it could have been.

Jo Ohlson (Brent Borough Director, NHS Brent and Harrow) advised the committee that list validation was not an unusual exercise. During 2007/10 a list validation exercise had been carried out resulting in some patients being removed. However 118,000 had not responded to letters and these were now subject to a further validation exercise. Ms Ohlson outlined the detail of the correspondence that was subsequently sent out (which included a translation offer) and the level of replies received. 38,000 people  had not responded to letters from the PCT and were due to be removed from GP lists. The gap between registered patients and residents of 100,000 was the highest in the country. Ms Ohlson advised that discussions were taking place on steps to be taken to assist vulnerable people and she assured the committee that practices would not be penalised for reinstating patients.

With the consent of the meeting Mr Irvin Van Colle, chair of the Kingsbury GP Consortium patient and public involvement forum questioned the extent to which the process was open and fair and made reference to one practice that was losing 25% of its patients. He acknowledged the importance of accurate lists but felt that reinstatement of patients would create a huge amount of unnecessary work and suggested that decision should be deferred on any practice that was likely to lose more than 5% of its patients. Mr Van Colle put that there could be many reasons why people had failed to respond to letters including not having English as a first language and that the removals should cease until the methodology had been reviewed.

Rob Larkman (Chief Executive, NHS Brentand Harrow) stressed the importance of accurate patient lists to help ensure that funding was being invested in the right areas. He stated that the methodology used was standard and in recognition of the sensitivities safeguards would be introduced for vulnerable people and those whose first language was not English. Further letters would be sent out. The Chief Executive indicated that practices adversely affected financially would be supported once the process was complete.

Members sought and received assurances that every effort would be employed to avoid removing vulnerable people and that requirements would be waived to reinstate them as easily as possible if necessary. Jo Ohlson offered to report back on the outcome. She advised that approximately £700,000 would be saved so far from the numbers removed accepting that this figure could reduce with re-registration.

Members heard that that there seemed to be some inconsistency between the policy and experience of practices involved in the validation process. Vulnerable patients had been removed from lists sooner than expected although Jo Ohlson confirmed that vulnerable patients on medication would be safeguarded and were also likely to exist on community records and therefore not included in the validation exercise.  She stressed the need for practices to respond urgently to notifications and not wait to appeal against removals until the last minute.

The committee heard that patients presenting themselves as unwell would be seen irrespective of whether they were registered and there was also the walk-in centre in Wembley in case of emergency. The committee heard that lessons were being learned from this experience. It was acknowledged that the process would have benefitted from  taking place over a longer period of time, the diversity of Brent's population needed to be taken into account and addressees to be clearly warned not to ignore correspondence.

The committee accepted NHS Brent's assurances that where patients had been removed from lists this had been justifiable and in any event re-registration was not complicated. The intention to consider reviewing lists on a more regular basis was noted.

The Chair certified this item as urgent in view of the level of public concern and as the deadline for removing patients from GP lists was on the 9 June.

RESOLVED:

that the briefing paper from NHS Brent on the GP list validation exercise be noted and an update on the be exercise presented to the next meeting.