Reviewed on : 17 May 2021

Reviewed by : GP Gateway Editor

Expires : 17 May 2023

Removing a patient from the GP Practice list

Practices have the right to ask for a patient to be removed from their list. In cases other than violence and abuse, the decision to remove a patient should only be made after careful consideration.

The removal of a patient from a GP practice list should be a rare event. Reasons include:

• Disagreement between the practice and patient and an irretrievable breakdown of the relationship
• Patient has died
• Patient has moved outside the practice area
• Patients have a right to change their practice

Procedure for removal

The following processes are followed under the relevant category, when removal of a patient is considered:

Immediate Removal

Processed by PCSE within 24 hours of receipt of notification from the GP practice via email.

The incident must have been reported to the Police for the immediate removal to be processed.

The form can be requested by contacting pcse.immediateremovals@nhs.net or download from the PCSE website here or follow link on right of page

8 Day Removal

An 8-day removal can be processed without police intervention and will require a GP signed request for removal.

The form can be requested by contacting pcse.immediateremovals@nhs.net or download from the PCSE website here or follow link on right of page

30 Day Removal

A GP Practice can deduct the patient via GP Links as a 30-day removal request.  PCSE will receive the request via the link and will write to the patient and place the patient on 30-day removal notice.  Your practice will receive a notification of this removal via the clinical system along with a message confirming that the patient will be automatically deducted within 30 days.  The deduction will be generated to the practice automatically after 30 days, unless the patient registers elsewhere in the meantime.

Further information on patient registrations/removals can be found here.

Warning a Patient

Where there has been a breakdown in the patient–doctor relationship, removal can be considered in accordance with the GMS contract, but only if during the previous 12 months the patient has been provided with a written warning that he or she is at risk of removal.

Warn the patient their behaviour is unacceptable which could end the GP/Patient relationship

Keep a record of any discussions and follow up the warning in writing.

Notify your local Primary Care Organisation (PCO) and NHS England Area Team in writing of your decision and the reasons, in line with your NHS contract.

Removal without warning can only occur if:

• The patient has moved outside the doctor’s practice area.
• The doctor has reasonable grounds to believe that issuing a warning would be harmful to the patient’s mental or physical health, or put practice staff at risk.
• It is, in the opinion of the contractor, not otherwise reasonable or practical for a warning to be given (GMS contract).

If a warning is given, the practice is required to produce a written record of the date on which it was issued, including the reason(s) for the warning as explained to the patient, or the reason why no warning was given.

Removing family members

If the behaviour of one patient has led to their removal, this does not mean the removal of other family or household members should automatically follow.

A clear discussion with other family members should take place, whilst protecting the patient’s confidentiality.

For more information and guidance on Patient Removals please contact the Primary Care Team at  PrimaryCare@coventryrugbyccg.nhs.uk