Immediate Removals

PCSE will reject a removal request when it does not meet the criteria outlined in the relevant section of NHS England Primary Medical Care Policy and Guidance Manual (PGM).

There are a number of common reasons for removal requests being rejected, please see some examples below:

• They have moved outside of the practice area and you do not wish to treat the patient under the Out of Area Scheme
• Mail has been returned as ‘undelivered’, or
• Whereabouts are unknown

NB: To remove a patient for the above reasons, please submit a request through the GP links.

• Patient no longer wishes to be registered at any GP surgery

It should be emphasised that NHS England and PCSE do not encourage this type of removal due to the potential clinical implications of patients being unregistered. It is encouraged that if patients are unhappy with the services provided by a GP practice that they are advised accordingly on how to register with a different GP practice and not to remove themselves from a GP list. However, if a patient no longer wishes to be registered at any GP surgery, PCSE place the patient on a pending deduction that runs for 14 days. To do so, the patient must send confirmation in the form of a signed letter expressing their desire to be removed. They can send this letter direct to the following address: Primary Care Support England, PO Box 350, Darlington, DL1 9QN.

Alternatively, the patient can direct this letter to their GP and the GP can scan and send the letter via email to pcse.patientremovals@nhs.net for action. Following this, the patient will have no recorded GP after 14 calendar days. PCSE will send out a confirmation letter to the patient providing their removal date. The GP requesting the removal should discuss this removal with the patient to ensure that they are aware of their options.

As PCSE are governed by NHS England policy, we are unable to provide any additional guidance and any complaints or further queries should be raised to your local commissioner. Please note that PCSE do not hold lists of commissioner details.

An immediate removal can only be requested via the enquiries form when an incident involving the patient has been reported to the police by your practice. 

A High Level Security Deduction only removes the patient from your clinical system and does not send a deduction request through to the system PCSE use or the Spine. High Level Security should not be used unless PCSE have instructed.

If a Special Allocation Scheme patient attempts to register with a mainstream GP Practice, no warning or preventative message would be received on the practice's clinical system. However, once the registration is received via the GP link, the flag on the patient's record warns PCSE that the patient is subject to the Special Allocation Scheme.

PCSE will then reject the registration with a rejection note stating the patient is on the scheme, and to remove the registration from the clinical system.  An email will also be sent to the Main Contact user role at the practice.

The patient will then be contacted by PCSE via letter to say that as they are still subject to the Special Allocation Scheme, they are unable to register at a practice of their choice and that their registration with your practice has been cancelled.

An immediate removal can be requested when an incident involving the patient has been reported to the police by your practice.

If there has been no police involvement, then commissioner approval is required.  The commissioner will need to fill in the ICB NHSE Approval Form.

The immediate removal of a patient results in them being allocated to a provider of the Special Allocation Scheme (SAS).

The most efficient way to submit a request to immediately remove the patient is to complete the Patient Removals form via the Contact Us page. 

*Immediate removal requests can also be made by phone by calling the PCSE Customer Support Centre on 0333 014 2884, or by email to pcse.patientremovals@nhs.net. 

As the patient is part of the SAS programme, this means they will need to be treated by a SAS practice. The patient will need to be deducted from your practice’s clinical system under high security/security-controlled procedures, and any booked appointments cancelled. The patient will receive a letter from PCSE with the details of their current SAS healthcare provider along with confirmation that their registration with your practice has been cancelled.