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.
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.
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:
“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.
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.
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.
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.
Mistakes to look out for and avoid
Practices following incorrect registration and deduction processes can affect patient care, exclude patients from ill-health prevention/screening programmes and result in non-payment for the patient.
1. Registrations or deductions made outside of NHAIS/Exeter and directly to PDS and/ or under ‘high security’ leave patients excluded from screening programmes, may effect patient care and may result in non-payment for the patient.
2. Deducting child patients under high security when they do not wish to partake in immunisation programmes excludes the patient from care.
3. Rejected, unmatched and unacknowledged transactions returned to the GP Clinical System by NHAIS/Exeter have the same result as above. The error message in the transaction should be read and actioned rather than the patient simply being re-registered.
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.
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: email@example.com.
Patient Registrations, Deductions and Amendments
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.
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
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 firstname.lastname@example.org (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 email@example.com to let us know, and include the following information:
• The name of new care home
• The full postal address of the new care home
Patient Records, duplicates and confusions
This is where two patients have the same NHS number – this often occurs when a patient registers with a practice, and the incorrect patient details are selected from PDS on the Spine, confusing the two patient’s details.
This can cause medical records to be combined for the two patients and can often result in the patient/s being registered between practices. Confusions carry a clinical risk, as they can result in a patient missing screening programmes and incorrect medical care being provided.
Confusions can be avoided by following the ‘tips for smooth patient registrations’ provided a little further on.
This is where you find one patient has two NHS numbers. Cases like this often lead to the medical records being mixed between two medical record envelopes, which could lead to the full patient history not being fully reviewed by practitioners.
Please notify PCSE of any confusions or duplicate cases. To do this, please go to www.pcse.england.nhs.uk/contact-us and select ‘Registrations’ from the drop-down menu on the enquiries form.
One notified, PCSE will investigate the case and update NHAIS. PCSE will then log a request with the National Back Office to update the data held on PDS/Spine. The National Back Office can take between 4 – 6 weeks to return to PCSE. We will then complete and close the case within five working days.
Adoption and Gender Re-assignment Processes
Guidance on how to register potential blood and organ donors on NHAIS can be found here.