NHS England says that GP practices will lose the funding they currently receive for so-called ‘ghost patients’, who have either died or moved away from the area.

GPs have been asked to produce a list of patients who have not been to the surgery in five years and private contractor Capita will send them two letters asking if they wish to remain on the list. If they do not respond, they will be dropped by the practice and will have to re-register if they wish to see a doctor again.

According to NHS England, cash is being wasted on paying for these patients but critics maintain that the crackdown will penalise those who don’t want to make a fuss and who don’t visit their doctor because they are generally healthy. The British Medical Association (BMA) said that people should “not be punished for being well”.

Until now it has been up to local areas to come up with their own ways of keeping lists up to date. They have used a variety of approaches, including following up people who do not respond to screening and immunisation requests and regularly checking on some patients, such as those who are elderly, students or have moved to England from abroad, if they have not been seen recently.

GPs are paid a basic amount for each patient they have registered on their list, even if they do not see them. It can vary from place to place, but in 2013-14 it was worth £136 per patient on average.

It is unclear how many patients are incorrectly registered. An exercise in 2009-10 identified 95,000 patients who needed to be removed, saving the NHS £6.1m at the time. However, in 2012-13 the NHS estimated that as many as 5 per cent of the GP register population might be wrong.