Medicopolitical Digest

Medicopolitical digest

BMJ 1994; 309 doi: (Published 26 November 1994) Cite this as: BMJ 1994;309:1444
  1. Linda Beecham,
  2. Jennifer Dixon,
  3. Naomi J Fulop

    BMA issues guidance on removing patients from lists

    The General Medical Services Committee is recommending to general practitioners that they should consider writing to patients when they remove patients from the practice list giving a brief outline of the reason. If they are in doubt about the wording the committee suggests they discuss it with their partners or the secretary of the local medical committee. It was also suggested at last week's meeting of the committee that doctors should consider telling patients if they are misusing the service and give them an opportunity to discuss the situation. This might lead to a change of behaviour and obviate the need to remove them from the list.

    General practitioners have a right to ask that patients should be removed and there is no contractual obligation to give a reason. They must tell the family health services authority or the health board, who notifies the patient. Similarly, patients have a right to change their doctor. They do not have to give a reason or even notify the doctor.

    Many of the removals occur because the patients have moved away from the practice area or have died. But there has been increased publicity recently about patients who have claimed that they do not know why they have been removed while some patients believe that they have been removed because of their clinical condition or because their care was too costly.


    The size of the problem has varied according to the source of the information. There are 34000 general practitioners in Britain and approximately 250 million consultations each year. The 1994 annual report of the Association of Community Health Councils in England and Wales claimed that about 30000 patients a year were being removed from lists, but the association admits that it does not know how many of the removals were voluntary. A …

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