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Registrations

New guide to registrations

The PCSE registration team have created a hints and tips guide to help ensure patients are registered at practices as smoothly as possible. Please click here to view.

PCSE processes new patient registrations and de-registrations at GP practices. We ensure that NHAIS (the national patient records database) reflects what is shown in each practice’s patient list.

Each quarter, we carry out a ‘close of quarter’ process to verify the quarterly patient list size for each practice.

Registering new patients at your practice

Whilst all clinical systems are slightly different, we have pulled together some hints and tips to help ensure patients are registered at practices as smoothly as possible.

  1. When completing the registration on your clinical system, please ensure that all details provided on the GMS-1 form are inputted. In particular, please ensure the following fields are complete:
  • Birthplace
  • Current home address including the postcode
  • Previous home address (where applicable) including the postcode

  1. When searching for a new patient using your clinical system it is important to use the exact details provided by the patient as there may be two or more patients with very similar details. Please be careful to select the right patient from the clinical system, as this will help prevent NHS numbers and / or records being duplicated or merged.

  2. To ensure all patient registrations are processed in the most efficient manner we recommend that the free text field (also termed ‘additional notes’ on some clinical systems) isn’t always used. The free text field is not mandatory and if text is entered this can stop the registration going through the system automatically, resulting in manual intervention at PCSE. This can delay the registration slightly as it will only be processed fully once the PCSE team have reviewed and actioned it.

    Here are some widely used examples of where free text is submitted but isn’t required:

    “Identification seen”

    “New registrations”,

    “New Birth/Baby”

    “GMS1 Signed”

    “Passport/Marriage certificate/ID seen”

    Example of how the free text field could be used:

    We would recommend that the free text field is used on the Clinical System for any additional information that would support and assist in tracing a patient or if re-registering a patient under Choice of GP e.g. where your practice agree to maintain the patient on their list but are not providing home visits.

  3. Patients moving to your practice from Northern Ireland and Scotland should be treated as a regular transfer in, as if they were moving from a practice in England.

  4. NHS number for new babies should always be provided. When registering new babies it is important to use the 'forename' and 'surname'. Often babies are registered with the word 'baby' and 'surname' which can lead to the incorrect NHS number being allocated to the baby.

  5. Most registrations are processed automatically.  Sometimes, registration requests fail the automatic checks.  This could be for a number reasons such as the personal information provided doesn’t match the information held on Spine, or where free text notes are included inappropriately.    When a request fails the automatic checks, it will then need to be processed by PCSE manually.  In these cases, PCSE will contact the practice to request the required information, which is required within 10 days of the registration being originally received.  If PCSE doesn’t receive the required information by day 10, then the registration will be rejected detailing the information still required.

Removal of patients from your practice list

Historically, there have been local variations in the immediate removals process. NHS England has directed that from 5 Feb 2018, all immediate removals will be processed by PCSE within 24 hours of receipt of notification from the GP practice – this can either be by phone or by email. The incident must have been reported to the Police for the immediate removal to be processed. Secondary or local commissioner approval will not be necessary.

The updated policy includes a provision for the Special Allocation Scheme (SAS) provider to determine whether the removal request is appropriate. Practices have been advised of this update and the process to follow to request removal of a patient from a practice list.  Guidance is also available on the PCSE website. 

PCSE is not responsible for determining if a patient meets the criteria for immediate removal, other than confirming the incident has been reported to the Police.  This is the responsibility of the reporting practice.

To request removal of a patient from your practice list (either immediate or within eight days), please complete the form which can be downloaded here. Once complete please email to: pcse.patientremovals@nhs.net.

 

FAQs

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 and select option 6.

As part of the services we provide, PCSE regularly writes directly to patients (for example through our screening administration, new patient registration, and practice merger and closure programmes).

In line with current procedures, if a letter is returned to PCSE as the patient has moved house, we are required to raise an FP69 flag on the NHAIS system. This will update the GP practice’s clinical system. The practice should then check the address directly with the patient, and confirm or update the address on their clinical system.

If PCSE doesn’t receive confirmation from the practice (via the link) that the patient is either still at the address or at a new address within 6 months of the FP69 flag being raised, the patient will then be removed from the GP’s patient list.  

Should the letter be returned to us as ‘moved abroad’ or ‘deceased’ the appropriate action would be taken to deduct the patient from NHAIS as O/R (other reason).

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.

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.

It is the responsibility of each practice to maintain its patient list. If you think there is a discrepancy between the patient list on your clinical system and the patient list PCSE hold for your practice, please email your patient list to PCSE at pcse.dataquality@nhs.net after the next quarter end period with the following information:

  • Your name
  • The name of your GP practice
  • The address of your GP practice
  • Your practice telephone number
  • The ODS code for your practice (GP main practice codes are a letter followed by five numbers)

PCSE will review your practice list. If necessary, we will send your practice a set of actions based on the outcome of the review. These actions will ensure that all patients are accurately registered and must be implemented as a matter of urgency.

Any delays in the validation process:

  • Create potential patient safety risks for safeguarding and access to wider health and cancer screening services
  • Risk the GP practice not receiving correct patient payments

Please can you email pcse.dataquality@nhs.net a week before the change takes place so that we can arrange to turn the GP Links off. Please include in your email a point of contact within your practice that PCSE can email/ telephone when the GP Links are turned off and back on. Please also include in the email :

  • your Practice Code,
  • the date you want the links to be turned off, and the date that the links need to be turned back on
  • who the new system supplier will be
  • a new DTS Mailbox Address  (your new supplier should be able to provide this)

 

PCSE will confirm the highest transaction number as this will need to be passed on to your new Clinical System Supplier so that they can increase the Practice Transaction Numbers to prevent duplications occurring, which can occur with system changes.

Yes.  If you move to a new practice, a new GP code will be issued to you as part of the Performers List change  notification process.  Please do not use your old GP code once you move to a new practice, as this would result in new  patient registrations being assigned to your previous practice, and the patient’s medical records would be sent to your previous practice.   Details on the performers list change notification process can be found here.

Please email PCSE at:  PCSE.Registrations-preston@nhs.net.  The registrations team will amend the patient prefix (i.e. Mr, Mrs, Miss) and update the male/female marker in NHAIS.  PCSE will then allocate the patient a new NHS number.

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.

Please do not action the change of address on your clinical system.  Please request a deduction with a reason of ‘Other Reason’/’Left Area’ and in the free text field include the text ‘OOAR’ or ‘Out of Area Registration’

Adoption process

It is important that practices are aware of the steps that need to be taken when a patient is adopted. Following the process will ensure continued patient care and ensure there isn’t an impact on your practice payments.

When a patient is adopted, they are given a new NHS number and must be registered as a new patient at your practice. All previous medical information relating to the patient needs to be transferred into a newly created medical record.

The process is as follows:

  • The National Back Office send the patient’s new NHS number and any other amended details (e.g. name, address) to PCSE
  • PCSE sends the GP practice a deduction notification for the patient and emails the main contact we hold for the practice (if available) the new details for the patient  
  • GP practice accepts the deduction and registers the patient using the new details provided by PCSE. Important: Do not update the patient’s original record with their new NHS number. If this happens they will not be registered and will miss out on continuity of care
  • PCSE sends a new patient medical record envelope with the patient’s updated details to the GP practice
  • GP practice creates new patient record using new details, and transfers all previous medical information from the original medical record. Any information relating to the identity or whereabouts of the birth parents should not be included in the new record.

 

It is important that practices complete the new registration for the patient within five working days to ensure no interruption to patient care.

For further information please see our guide for GP practices.

 

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.

Guidance on how to register potential blood and organ donors on NHAIS can be found here

Gender re-assignment process

It is important that practices are aware of the steps that need to be taken when a patient changes gender. Following the process will ensure continued patient care and ensure there isn’t an impact on your practice payments.

When a patient changes gender, they are given a new NHS number and must be registered as a new patient at your practice. All previous medical information relating to the patient needs to be transferred into a newly created medical record. When the patient informs the practice that they wish to change gender, the practice must inform the patient that this will involve a new NHS number being issued for the them, which is not reversible. To revert back to their original gender, they would receive a third NHS number. The practice should confirm this has been discussed with the patient when notifying PCSE.

The process is as follows:

  • GP practice notifies PCSE that a patient wishes to change gender via the enquiries form. The practice should include the patient’s name and NHS number in the notification to PCSE, plus confirmation that they have discussed with the patient that this will involve the creation of a new NHS number
  • PCSE sends the GP practice a deduction notification for the patient and emails the main contact we hold for the practice (if available) the new details for the patient  
  • GP practice accepts the deduction and registers the patient using the new details provided by PCSE. Important: Do not update the patient’s original record with their new NHS number. If this happens they will not be registered and will miss out on continuity of care
  • PCSE sends a new patient medical record envelope with the patient’s updated details to the GP practice
  • GP practice creates new patient record using new details, and transfers all previous medical information from the original medical record. Any information relating to the patient’s previous identity should not be included in the new record.
  • If the gender is being re-assigned from male to female, the screening team will contact the practice for no cervix confirmation
  • If the gender is being re-assigned from female to male, screening will become the responsibility of the practice.

It is important that practices complete the new registration for the patient within five working days to ensure no interruption to patient care.