There are plenty of methodologies for systematically validating list of patients registered with primary care trusts to identify 'ghost' patients - those who no longer live at their recorded address or do not exist.

There are plenty of methodologies for systematically validating lists of patients registered with primary care trusts to identify 'ghost' patients - those who no longer live at their recorded address or do not exist.

Although lists can be kept reasonably current by proxy measures such as referring to vaccination records of children, cervical smear programmes for women over 25 and flu vaccinations for those over 65, but these miss women under 25 and men under 65.

We analysed a database of 109,990 patients (men under 65 and women under 40) registered with GPs in Heart of Birmingham teaching primary care trust. We attempted to identify ghost patients by running a query on habitation patterns.

To identify patients living in residential, retirement and nursing homes we queried the database using a list of residential and nursing homes in the locality downloaded from the internet. We expanded this search by using keywords 'residential', 'nursing', 'care', 'home' and 'retirement'. This yielded 148 names in 37 nursing homes. Of the 109 patients we successfully contacted, 11 per cent were no longer at their registered address and are therefore ghost patients.

Across Birmingham this would equate to some 900 ghost patients in nursing and residential homes, and 40,000 in England and Wales.

With each registered patient attracting a capitation fee for the GP practice of£54 a year, this could equate to£2.16m a year being wasted on nursing and residential homes ghost patients in England and Wales.

Terry Jones is a pre-registration house officer in general and breast surgery at Sandwell and West Birmingham Hospitals trust's City Hospital Birmingham. t.a.jones@dentmail.com