Deductions, amendments and rejections

We would recommend that you give full and accurate information for each patient with a preference for information that would be already held on the Spine from previous practices or other healthcare visits. We are essentially making sure we have the correct patient at the right address.

We commonly use the code 3 rejection which is confirmation of the patient’s current address. You can use royal mails postcode finder or google to confirm that the address is valid or formatted correctly to make sure they can receive mail correspondence from the NHS.

Common reasons for rejected registrations - https://pcse.england.nhs.uk/sites/default/files/2023-08/10-common-reasons-for-registration-rejections.pdf 

This needs to be discussed with the patient, you should explain that NHS systems require a patient to have a forename and surname. For example, you could ask if a duplication of his first name in both fields is ok. If not, then you will need to come to some agreement with the patient on what can be used for their surname (such as XX). Something needs to be in this field when registering the patient, or the registration will be rejected.

Yes, you will have to deduct and re register the patient with the correct Out Of Area Registration text that is listed on the PCSE website. Sending an address amendment with the OOAR free text will not set the patient correctly. https://pcse.england.nhs.uk/help/patient-registrations/deductions-amendments-and-rejections

Please note, you need to ensure that the correct message is sent in the GP notes. OOA means that the patient has left the area, OOAR means that the patient is an Out of Area Registration.

Yes Mx is an accepted title. 

PCSE use Royal Mail’s postcode finder to help verify and format addresses. 

You can also use it to make sure the address is valid or formatted correctly. This is especially an issue for addresses with apartment buildings, flats, room separation, student accommodation and new builds.

PAF is the Postcode Address File which is supplied by the Royal Mail. You can verify addresses on the PAF via the Royal Mail Postcode Finder website.

Royal Mail Postcode Finder website: https://www.royalmail.com/find-a-postcode

Where a patient has died, the request for deduction should be made through the practice's clinical system. 

If an online form is submitted, it will be rejected.

When a patient dies, their death is recorded by the General Registry Office. This sets off a process to record the death on their Spine/PDS record which generates a deduction to your practice's clinical system.

PCSE are not made aware of details surrounding the death.

It is extremely rare, but a death notification can be recorded against the wrong the patient. If you have reason to believe the patient is not deceased, please email pcse.registrations-preston@nhs.net and enquiries will be made with the National Back Office (NBO). 

If you have already resubmitted the registration, please disregard the email from PCSE and from your Commissioner.

The rejected patient registration will be in a file on your clinical system, please contact your system supplier if you are unsure where the file is located. Once located, you should be able to access the registration from here and make any amendments before resubmitting the registration.

If you cannot locate or edit the rejected registration will need to follow these next steps:

• Approve the registration under high security, in order to do this you may need an NHS number. As the patient may not yet have been allocated an NHS number, especially if they are registering from outside of England or Wales you can use a dummy NHS number e.g. 999 999 9999.
• Once approved, deduct the patient under high security so that they are showing as inactive
• Proceed to re-registering the patient, adding in any additional information in the appropriate fields and removing the dummy NHS number

Once PCSE receive the registration we will either trace an NHS number or allocate and you will receive a notification on your clinical system.

When a registration has been rejected it is no longer visible on NHAIS and cannot be amended or processed by PCSE, therefore you will need to make the necessary amendments on your clinical system as explained in the email from us and resubmit a registration through the GP link.

When you resubmit the registration with all the information required, we will process and accept the registration.

Yes, you can change your registered PCSE main contact by calling our Customer Support Centre on 0333 014 2884.

Emails about rejected registrations are sent to the registered PCSE main contact at your GP practice.

If you need to change your main contact details, please call the Customer Support Centre on 0333 014 2884.

Check that the practice code in the email subject line relates to the practice you work for. If this isn’t your practice you should check who the main contact is at your practice. If you need to update your main contact please contact our Customer support centre on 0333 014 2884.

If you do work at the practice, please do a full search on your clinical system for the patient using all the details provided in the email. If you still cannot trace the patient, please contact us.

Depending on the reason for rejecting the registration, a numeric code is assigned to the registration, and we notify you in two ways.

Email

An email is automatically sent to the main contact at your practice, with specific information on the reason for rejection and what needs to happen next.

Clinical System

A message is sent to your clinical system, with the numeric code and the text "Email has been sent to the main contact at your practice"

You can find out more about the numeric code and reason for rejection, along with what needs to happen next in our Rejection Codes document. 

There is also more specific information in this section below on:

• Notifying us of a change of main contact

To request a change of address for a patient registered at your practice, please ensure you have seen a document displaying proof of address and have confirmed the address on the Royal Mail Postcode Finder which can be found at https://www.royalmail.com/find-a-postcode. 

This allows our system to match the address and the amendment to be processed.

To request a change to the title information for a patient registered at your practice, please submit the amendment via the GP Link, and confirm in the free text that you have seen documentation with the correct title. If this confirmation isn’t provided in the free text, then the amendment will be rejected.

If the title change is in relation to a patient undergoing gender re-assignment, please see our FAQs on Gender Reassignment.

To request a change to the name information for a patient registered at your practice, please submit the amendment via the GP Link. PCSE do not need to be notified of any evidence seen at the practice, however, if the name change is to the patients forename or both names, it is advisable to confirm in free text that the details are correct. PCSE may query changes where we believe there could be a data quality issue.

To request a change of date of birth for a patient registered at your practice, please submit an amendment via GP Links. 

From 22 January 2024, PCSE no longer require confirmation what evidence (if any) of the amended date of birth has been seen by the practice. Practices no longer need to provide this information in the GP message/Free text when submitting the amendment. 

PCSE will continue to undertake checks on receipt of a different date of birth, to ensure there are no data quality issues, but will otherwise accept the amended date of birth. 

An immediate removal is where there has been an incident involving the practice or practice staff where the police have been called. Requests for these should be submitting via the Patient Removals online form.

Where a patient has died, the request for deduction should be made through the practice's clinical system. If an online form is submitted, it will be rejected.

If you wish for a patient to be registered at the practice on your “Out of Area Scheme”, you will need to send a removal request for the patients through the GP Link as a deduction with 'OOA REG' or 'OUT OF AREA SCHEME' in the 'GP Message' field.

When this is received, the patient will be removed and the practice must accept the deduction notification received. This deduction process can take up to 5 working days to be received on the GP clinical system. If the patient has been put on a 30 day deduction, please email pcse.registrations-preston@nhs.net with the patient details with 'OOAR deduction' in the subject line.

Once the patient deduction notification has been received, the practice should then send a new registration request down the GP Links system with any of the following agreed text strings listed below in the GP message field:

• "OUT OF AREA REG"
• "OOAR"
• "OUT OF AREA SCHEME"
• "OOA REG"
• "PC-OOA"
• "PCS-OOA"

This re-registration can then take up to 5 working days to be received on the practice system.

Please do not deduct the patient under high security/security controlled procedures as this will only update your clinical system. It will not remove the patient on Open Exeter or the National Spine. All deductions should be sent via the GP links.

Please do not action the change of the address on your clinical system. Please request a deduction with a reason of ‘Other Reason’/’Left Area’ and in the free text include the new address including house number/name, street and postcode. If you do not know the patient’s forwarding address please enter ‘Address Unknown’.

Once the deduction is received, PCSE will place the patient on a pending deduction for 30 days. A letter will then be sent to the patient at their out of area address, or last known address if the new one is unknown informing them they need to re-registered with a different GP practice. The deduction request will be rejected as the patient will only be deducted on the 30th day or upon a registration being received from a practice.

If you need to cancel a patient deduction request which you have sent to us via your clinical system, please note that removing the flag on your local clinical system will not update the request into PCSE.

To inform PCSE that you need to cancel a patient deduction request, please either email the registrations team at: pcse.registrations-preston@nhs.net  putting ‘Cancellation of deduction request’ in the email subject line, or call PCSE on 0333 014 2884.