Confusions

A confusion occurs when two or more patients are mistakenly linked to the same NHS number in the Personal Demographics Service (PDS). This can lead to:

• Incorrect treatment or medication
• Combined or misdirected medical records
• Exclusion from screening programmes
• Data breaches and confidentiality violations
• Clinical decisions based on inaccurate information.

Confusions are considered a serious data quality issue and a risk to patient safety.

Typical resolution time: 10 weeks. However, this is largely dependent on the National Back Office’s (NBO) timelines and the speed of responses from practices involved.

The process involves multiple steps and third parties: 

• PCSE will need to contact all the practices involved in the confusion and await a response from them.
• In order to confirm the correct information practice(s) may be required to contact their patient directly.
• Once PCSE are satisfied enough information has been gathered a case is logged with the NBO to resolve the confusion on the PDS (Spine).
• The NBO may need to contact the Home Office to verify information if the confusion involves an immigrant patient.
• The NBO investigates and corrects the PDS (Spine) for all patients involved and notifies PCSE.
• PCSE will contact all practices involved with a request to examine and correct the patient records. There may also be a request to re-register the patient or register the patient with a new NHS number.

 Always verify patient details carefully during registration: 

• Full name (including middle names)
• Date of birth
• Previous addresses and GP details
• Date of entry into the UK (If they are from abroad)

• A confusion is only when two patients share the same NHS number on PDS (Spine).
• If the issue is demographic (e.g., wrong DOB or address on the PDS) but NHS numbers are correct, it is not a confusion—it is a data quality error.  In this scenario please submit a New Patient Registrations Enquiry in the contact us section on the PCSE Website.
• Filling in the confusion form when no confusion has occurred will cause a delay in your query being answered.
• If you are unsure which category your query relates to please submit a New Patient Registrations Enquiry in the contact us section on the PCSE Website. 

• Complete the 'New Duplicates and Confusions Enquiry' form on the PCSE Contact Us page.
• Provide as much detail as possible (previous addresses, names, place of birth).
• PCSE can only send patient identifiable information to staff members who are verified contacts at the practice on PCSE online.

• Gather full details (DOB, previous addresses, GP history) and submit via the Duplicates and Confusions form on the PCSE Contact Us page.
• PCSE will confirm if it is a confusion or a duplicate.

Please refer to the timescale guidance before requesting an update.

• Click here to go to the Duplicates and Confusions Contact us page and select 'Existing Duplicates and Confusions enquiry'.
• Include the CAS reference number in your submission.
• Ensure you respond promptly to any PCSE or NBO requests for additional information (e.g., previous addresses, names, place of birth).

Electronic records:

• Ensure that the clinical system record holds the correct NHS number.
• Remove any notes belonging to the other patient.
• Any clinical information that relates to the other patient(s) involved in the confusion should be returned to PCSE.
• Please contact your clinical system supplier for assistance on how to action the above steps if required.

Physical records:

• Any printed notes belonging to the other patient should be placed in a Lloyd George envelope.
• Request a label via PCSE Online and forward the envelope via the ‘Not my record’ section of PCSE online.  Take a look at the Medical Record Tracking Labels video on the PCSE YouTube channel. 

Impact of clinical information present in the incorrect medical record:

• Breach of confidentiality.
• Clinical risk due to incorrect information (e.g. Test results held against an incorrect patients record)
• Incorrect treatment delivered.
• Potential regulatory consequences for the practice.