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8 Day Removal

What is the purpose of an 8-day removal?

8-day removals are requests to remove a patient by the GP as a result of a breakdown in relationship between the GP and the patient, for example due to repeated non-attendance of appointments (DNA).

How to inform PCSE of an 8-Day Removal

Online Form 

The preferred notification method for the most efficient processing is via the Request for Removal From Practice List Form.   

Please note 8-day removals cannot be requested by calling the Customer Support Centre. If you are unable to use the online form, you can also contact PCSE via email. 

Email 

Please complete the Removal Request Paper Form and email to pcse.patientremovals@nhs.net    

What to consider

Before submitting a request you should ensure that the criteria outlined in the NHS England Primary Medical Care Policy and Guidance Manual (PGM) (Section 3: Managing Patient Lists Subsection Removing a Patient from a Practice List) has been met.

Please note that in the case of patients under the age of 18, confirmation that the Safeguarding Lead has been consulted must be provided.

The practice must carefully consider the circumstances of any incident and assure itself that the removal request is not as a direct result of the patient’s protected characteristics and key past medical history including mental illness, learning disability and neurodiversity.

What happens once your request has been submitted?

Requests are typically processed within 24 hours of being received, unless the request is not valid.

After a request has been validated as meeting the criteria, the following actions are taken by PCSE:

  • A removal is applied to the patient’s PDS record, with an effective date of 8 days in the future.
  • A patient notification letter is sent first class to the patient's current address.
  • The patient notification informs the patient of the practice’s decision to remove them, the date the deduction will be finalised and advises them of what action they now need to take, to register elsewhere.
  • A notification will be sent to the GP practice that the request has been processed.
  • The patient will be deducted after 8 days, unless a registration is received from another practice sooner.

If you require any further guidance in regards to 8-day removals, please contact your local commissioner. Please note that PCSE do not hold lists of commissioner details.

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).

Common reasons for rejection of removal requests

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

  • Patients under the age of 18 where it has not been confirmed that the Safeguarding Lead has been consulted.
  • 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

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

Here are some more detailed examples of why your removal request may be rejected.

Patient was not given a warning within 12 months and the reason for not giving the warning was not confirmed by ticking the relevant box

GP Practices should provide the patient with a prior warning, before requesting a deduction unless there are extenuating circumstances – please refer to the PGM.  If a request is received that does not meet the criteria it will be rejected by PCSE with any additional information requested. 

Upon receipt of a valid request, PCSE will process it within 24 hours and the patient is notified. Warnings given to the patient should be within 12 months of the 8-day removal request.

Patient no longer wishes to be registered at any GP surgery

It should be emphasised that NHS England and PCSE do not encourage patients to remove themselves from a GP practice 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.

Further information

Take a look at our 8 day removal FAQs.

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