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Patient Registrations, Deductions and Amendments

New registrants include babies, patients recently arrived from overseas and any other patients who have an NHS number allocated for the first time at the point of registration.

All new registrants to the NHS will be issued a new medical record envelope (also known as the Lloyd George envelope) that will be sent to the GP with whom they registered. This will arrive on your usual weekly courier delivery that delivers and picks up your records requested for movement / transfer.

PCSE will then send a new registration letter directly to the patient’s home address.

Replacement registration letters or medical cards are not provided. If a patient needs their NHS number, they can get this from their current GP.

The patient will only receive a confirmation letter for a registration of a birth, or if they have never previously been registered with a GP practice and have a first time registration.  Immigrants, and people registering for the first time after moving into the country will also receive a letter.

Registrations are usually processed by PCSE within 3 working days but it can take up to 10 working days. If you have not received an acknowledgement to a new registration within 10 working days this indicates there may be an issue with the GP link and you should contact us to check the status of the registration.

You can download a guide for practice staff on the supplementary questions section of the GMS1 form, information on how to process them, and other frequently asked questions here.

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.

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 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' in the 'GP Message' field. When this is received, the patient will be removed immediately and the practice must accept the deduction notification received. Once this has been done, the practice should then send a new registration request down the GP Links system, again with ‘OOA Reg’ in the GP message field.

To request to change date of birth 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 date of birth. If this confirmation isn’t provided in the free text, then the amendment will be rejected

Practices should only use High Security when requested to do so by PCSE. 

Any actions carried out under High Security update the clinical system ONLY and results in no GP links transaction being sent to PCSE. 

High Security should only be used as a corrective measure for failed GP link transactions. 

Typical examples of when High Security should be used are as follows:

  1. Patient is active on the clinical system but not registered with PCSE

This indicates that a patient’s registration has been approved under high security. Practices should manually deduct the patient under high security using their security password, come out of high security and then send a new registration through the GP links system as if they are registering them the patient for the first time.

  1. Patient has been deducted by PCSE but remains registered on the clinical system

This indicates that no deduction has been received through GP links and therefore the practice is required to manually deduct the patient under high security.

  1. Patient’s registration is unacknowledged on the clinical system but is registered with PCSE.

The practice needs to manually approve the registration under high security. This will remove the patient from the ‘unacknowledged list’ on the practice’s clinical system.

If assistance is needed in manually deducting/approving registrations, please contact your clinical system supplier.

Please note:

  • All deductions should be sent via the GP links system
  • Patients should not be manually deducted from your clinical system unless this is requested by PCSE
  • Manual deductions made under High Security will only remove the patient from your clinical system and will not remove them from the national spine system or PCSE system records. All three systems should match
  • In the event that a manual deduction is made under High Security, please inform PCSE via email, stating the reason for the deduction and a forwarding address for the patient.

Please register the patient as normal. In the field for the patient’s address, please enter the full address for the GP practice including the practice postcode, putting CO (Care of) at the start of the address.

Please note, putting ‘no fixed abode’ in any field would cause the registration request to be rejected.

Guidance on Residential Institute (RI) Codes

• Adding a Residential Institute Code to a patient record is the responsibility of GP practices
There are currently a number of different processes used in different areas to link patients to residential institutes.  To make things simpler to follow, two new RI codes have been created that can be used nationally 
V0 – is to be used for patients who reside in a care/residential home
Y0 – is to be used for students who are residing at a school or university.
• Please note that the 0 in the code is a zero
• You will need to set both these codes up on your clinical system in order to add them to patient records. Practices are not required to recode all previous RI codes.
• Please ensure you use the correct code for the type of patient

Please inform us if a new care home opens in your practice area.

• PCSE maintains lists of care/residential homes. In order for the V0 RI code to be added to a patient’s record on NHAIS/Exeter, the care home must be listed with PCSE and on the NHAIS/Exeter patient registration system
• If a new care/residential home opens within your practice area, you will need to contact PCSE so that the care/residential home can be added to the list by emailing pcse.registrations-preston@nhs.net (see details below)
• Please ensure that the home is listed with the Care Quality Commission before requesting it is added to the list of homes
• This should not stop you from registering patients immediately as the RI code can be added to the record once PCSE has confirmed the home has been added. You will need to register the patient as usual, then once PCSE has confirmed the care home has been added, you will need to add the code to the patient record and send to PCSE as an amendment via GP links.

If a new care home opens in your area, please email pcse.registrations-preston@nhs.net to let us know, and include the following information:
• The name of new care home
• The full postal address of the new care home

  • For patients registering in England for the first time having previously been registered in Scotland, Northern Ireland or Wales, please select the registration type on your clinical system that you would if the patient was registering from another area of England and include their previous address. This will ensure that PCSE have the necessary information to request the medical record from the patient’s previous practice
  • PCSE will then process the registration and send confirmation to the practice via the clinical system
  • The National Back Office will initiate the deduction of the patient at the previous practice which triggers the request for them to release the medical record for transfer on to the new practice
  • The previous GP practice releases the record to the relevant Health Board who send the patient record to PCSE via courier
  • PCSE locates the new practice details, and sends the patient record to the new practice via CitySprint, with their usual records delivery.

Please note:

  • GP2GP will not work for patients transferring from GP practices in NI and Scotland
  • PCSE is reliant on the timely release of the patient record from the old practice in order to send it on to the new practice