Adoption

Overview

It is important that practices are aware of the steps that need to be taken when a patient is adopted. 

Covered on this page are the topics shown below. These will ensure continued patient care and prevent any impact on your practice's payments:

• What happens to a patient’s registration when they are adopted?
• What do we need to do when we receive an adoption notification?
• How should we handle the patient’s medical record?
• We have an adopted patient but have not yet received a notification

What happens to a patient’s registration when they are adopted?

• Once a week the National Back Office (NBO) receives notification from the General Register Office (GRO) of all adoptions in England and Wales after an entry has been made in the Adopted Children’s Register.
   
• For each patient on the notification, the NBO will invalidate the pre-adoptive NHS number on Patient Demographic Service (PDS). At this point, the patient will be deducted from your practice.
   
• The NBO issues a new NHS number for the patient in their post-adoptive details and informs PCSE.
   
• You will receive a notification from PCSE explaining that the patient has been adopted and that a new registration will need to be completed with the new NHS number. 
  
  This will be emailed to the practice’s main contact on PCSE Online.
  (If you need to update your practice contacts on PCSE Online, please visit the PCSE User Management section).
   
• The practice should now register the patient with their new NHS number once the notification is received.
   
• Upon completion of the registration, PCSE will send a new patient medical record envelope with the newly updated patient details and new NHS number to the GP practice.

What do we need to do when we receive an adoption notification?

• Accept the deduction request received on your clinical system for the pre-adoptive NHS number.
   
• Create a new patient record using the post-adoptive details outlined on the adoption notification.
   
• Register as a new patient on your clinical system, using the post-adoptive details.
   
• The pre-adoptive and post-adoptive records should then be merged. This will ensure a continuous health record for the patient.

How should we handle the patient’s medical record?

• Once the new NHS number has been registered, the pre-adoptive and post-adoptive records on the practice clinical system should be merged.  This will ensure a continuous health record for the patient.
   
• When ensuring continuous health records for an adopted child, we ask that you follow the Key principles, outlined below.

We have an adopted patient but have not yet received a notification

If your practice becomes aware that a patient has been adopted, but no adoption notification has been received from Primary Care Support England (PCSE), please follow the guidance below.

Why You May Not Have Received a Notification Yet

If you have not received an adoption notification this could be because:

• Adoption is a legal process that must be formally completed through the courts. PCSE cannot act until the NBO receives official confirmation that an adoption order has been granted, and the child’s details have been legally updated.
   
• If the NBO has not yet been able to trace the pre‑adoptive record or is still awaiting the court‑confirmed adoption order, no notification can be issued to the practice.
   
• Therefore, the absence of a notification usually means that PCSE has not yet received the confirmed details from the NBO.
   

If you believe that an adoption may have been missed (e.g. you are aware that the patient has been adopted for an extended period, but are yet to receive notification), follow the below steps: 

1. Submit an Enquiry to PCSE

• Go to the PCSE Adoption, Gender Reassignment & Sensitive patient query form on the PCSE website.
• Select ‘New Adoption, Gender Reassignment, and Sensitive Patient Enquiry’.
   

2. Provide Any Evidence You Have

To help NBO trace the adoption details as quickly as possible:

• Attach any supporting evidence your practice has regarding the adoption (for example, confirmation from social services, safeguarding teams, or adoptive parents where appropriate).
• This information is passed securely to the NBO to support their tracing and verification process. 
   

3. Await PCSE Follow‑Up

Once submitted:

• PCSE will liaise with the NBO using the information provided.
   
• If the NBO confirms the adoption, PCSE will send: 
   
  • A notification to your practice confirming the patient’s pre‑adoptive NHS number has been invalidated.
  • Details of the new post‑adoptive NHS number and instructions to submit a new registration.
  • Guidance on appropriate handling and redaction of medical records.
     

4. Do Not Create a Manual Deduction or Registration Prematurely

The practice should not manually deduct or re‑register the patient unless:

• PCSE has instructed you to do so, or
• The deduction has already arrived via your clinical system from NBO.

This avoids errors caused by mismatched NHS numbers or out‑of‑sequence records.
 

5. Keep Contact Details on PCSE Online Up to Date

Adoption notifications are emailed to the practice via the main contact recorded in PCSE Online, so please ensure your contact information is up to date.

(If you need to update your practice contacts on PCSE Online, please visit the PCSE User Management section).