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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. 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.

  2. 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.

  1. NHS number for new babies should always be provided.

  2. 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

To request removal of a patient from your practice list, please complete the form which can be downloaded here and email it to: pcse.patientremovals@nhs.net

This form and email address should be used for immediate removals (patients who need to be referred to the Special Allocation Scheme) and for standard eight day removal requests. 

For immediate removals, the incident must have been reported to the police and a police incident number needs to be provided to PCSE within seven days. Immediate removal requests will be processed within 24 hours of receipt of the form.



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.

It can sometimes take time to process and send out the letters to patients. It should be with the patient in the coming weeks.

It is likely that the change is still being processed on our system, through SPINE. It can take some time for the change to be validated, so please wait a few days and check the system again. If it is still not visible, then please contact us.

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.