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1 March 2016, 14:15 | Updated: 1 March 2016, 14:19
Patients who do not visit their GP for five years could be barred from their doctor's surgery under plans being developed in the East of England.
Under the move, patients who have not seen their GP for five years will be sent two letters asking them to respond. If they do not get in touch to say they still wish to be registered with their GP, they will be removed from the GP practice list.
GPs are paid for every patient on their list - in 2013/14, the average GP practice received funding worth #136 per registered patient. The drive by the NHS England regional team - known as "list cleansing"- is intended to cut costs to the NHS.
The idea is to find out whether patients no longer require services or have moved house, left the country or died.
Pulse magazine, which published details of the plan, has also carried out its own investigations which suggests thousands of "ghost patients" have been inappropriately removed from GP lists in recent years.
The NHS England East of England team sent a letter to groups of GPs known as local medical committees (LMCs) stating that people who had not seen their GP for five years "may be the people who no longer require services" and may be in "incredibly good health".
It said list validation was necessary "to protect NHS money and ensure patient lists are not artificially inflated".
But GP leaders said the move would increase their workload and could disproportionately affect some groups, such as adolescents.
Cambridgeshire LMCs said it had data that showed some groups, particularly children in early adolescence and men aged 20 to 45, could be disproportionately affected by the move.
In a letter to practices, Cambridgeshire LMCs said it was very concerned by the move "on grounds of discrimination, on grounds of workload, on grounds of making care for children and middle aged men less accessible."
The LMC added: "We note the true motive for this proposal from NHS England is, as they say, 'to protect NHS money and ensure patient lists are not artificially inflated'.''
Cambridgeshire LMCs chief executive Dr Guy Watkins told Pulse that children aged eight to 15 would be affected "because they're post routinely being seen, post most childhood illnesses, but actually they're not being routinely brought by their parents".