Removing Patients from Practice Lists

Question 1

What are some examples of situations that may justify removal from a practice list?

Answer 1

• Unacceptable behaviour: for example violence, sexual harassment, stalking, racial abuse
• Crime and deception: for example fraudulently obtaining drugs, stealing from the practice
• Distance: a patient moves outside the catchment area.
  
  • Please note from January 2015 practices are now able to register patients outside of their catchment areas. This is however voluntary and practices are able to decline to register patients if they feel the distance is impractical

Question 2

What are some examples of situations that do not justify removal from a practice list?

Answer 2

• Clinical matters: patient choice, for example refusing to attend for health screening or not bringing their child for immunisations
• Critical questioning and/or complaints
• Where there is an exacting or highly dependent patient, condition or disability
• Patients with a high levels of anxiety or demand about perceived symptoms due to age, gender, ethnic origin, religion or sexual orientation

Question 3

What should be done if there could be an irretrievable breakdown in the doctor patient relationship?

Answer 3

A formal process should be agreed to try and rectify the problem rather than unilaterally declaring an irretreivable breakdown without giving any reason to the patient.

Question 4

What steps should be followed when removing a patient from the practice list?

Answer 4

1. Give warning to the patient
2. Inform the clinical commissioning group in writing
3. Write to the patient

Question 5

Where do these guideliens come from?

Answer 5

The Royal College Guidelines in 2004

Question 6

if a patient is removed from the practice list, should their family be removed aswell?

Answer 6

Ideally no

But in some circumstances it may also be necessary.