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Removing Patients from Practice Lists

Most removals from the GP list are for administrative reasons e.g. the patient has left the practice area or has died. You can, however, also remove patients from your list if there is an irrevocable breakdown in the doctor-patient relationship or violence.

When considering an irrevocable breakdown you may wish to read the GMC guidance on "Ending your professional relationship with a patient".

You will need to comply with GMS regulations. (See the equivalent PMS regulations)

Breakdown in the Relationship

GPs have the right to request that any patient should be removed from their lists where a written warning has been issued in the preceding 12 month period.  Where a practice has reasonable grounds to remove the patient from its list of patients, it must inform the primary care organisation in writing, and must notify the patient in writing of the reasons for removal. This process is manged by PCSE (on behalf of NHSE). 

However, where the practice believes that it is not appropriate to give specific reasons, it is sufficient to state that there has been an irrevocable breakdown in the relationship between the practice and the patient. Care should be taken to ensure that the reasons given are factual, and that the tone of the letter is polite and suitably informative.  

Violent Patients

If the patient has committed an act of violence or behaved in such a way that staff fear for their safety, then the practice can ask for an immediate removal.

Once you have notified PCSE, then responsibility passes to them. The patient can continue to receive primary medical services via the Special Allocation Scheme (SAS). PCSE will write to the patient about this and they should also ensure their record is flagged to stop the patient registering at another practice.

Further Reading:

Wessex LMCs Zero Tolerance Guidance Document

NHSE Information about the Special Allocation Scheme (SAS)


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Updated on Friday, 2 September 2022 12902 views