'Ghost patients' lead to NHS fraud allegations

17th June 2019 Business Crime

This week saw reports of the NHS being investigated following suspicions that General Practitioners are claiming for non-existent patients, also known as “ghost patients„.

It was reported that doctors receive £150.00 a year for each patient on their lists, some of which may not in fact exist. Examination of records revealed an increase in patients attending their GP surgery of 3.6 million, raising queries as to how many of these patients are in fact “ghost patients„. In response, the NHS counter Fraud Authority are now due to launch an investigation into the number of non-existent patients and the impact that this has on the claims being made by GPs. If a GP is entitled to claim £150.00 per year, per patient, it has been alleged by some media outlets that this amounted to £88 million per year in funds being claimed for non-existent patients.

Whilst the investigation is due to commence, it may well be the case that so called “ghost patients„ occur in instances where patients have passed away without their records being updated, moved away without updating their records or other similar circumstances.

Allegations have been unsurprisingly met with protests from those within the NHS and in particular GPs. It is reported that the intimation that GPs are complicit in defrauding the health service is unfounded and reports of ghost patients are in fact due to administrative failings. In circumstances where patient lists are no kept up to date it is arguable that the system is left open and vulnerable to fraud.

What are the potential consequences?

It is currently unknown how long the NHS counter Fraud Authority investigation will continue for, its scope and what the findings will be. In the meanwhile consideration should be given to the potential disciplinary proceedings or criminal charges that individual practitioners could face. In circumstances where a practitioner has falsely claimed for a non-existent patient when they in fact know or suspect that the individual is a “ghost patient„ the potential consequences would be severe. Individuals and also those deemed complicit in making such representations could face charges under the Fraud Act 2006 and face significant fines as well as potential custodial sentences.

JMW Solicitor’s Business Crime and Regulatory Partners and Solicitors have extensive experience and knowledge in advising upon serious allegations of fraud and professional disciplinary proceedings. For further information about the comprehensive service our lawyers can offer if you are concerned about potential or ongoing proceedings. We are able to take on cases from anywhere across the UK and abroad. The author of this blog, Catherine O’Rourke, solicitor within the department can be contacted on 0161 828 8377 or catherine.orourke@jmw.co.uk

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Catherine O'Rourke is a Solicitor located in Manchester in our Business Crime & Regulation department

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