A Guide to Patient Registrations
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.
To keep you up to date with patient registration processes, we have produced a simple and easy to use Guide to Patient Registrations which is available to download here.
We hope you find the information useful. You can either download the complete guide via the link above, or go directly to the separate sections using the links below.
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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.
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: firstname.lastname@example.org.
Patient list data quality checks are carried out to reduce the number of patients incorrectly registered with GP practices. The checks ensure that details held on PDS/Spine are accurate. There are many reasons to ensure practice lists are current and accurate; it helps to ensure that patients are included in relevant screening programmes and ensures that practices are paid correctly for the number of registered patients they have.
The data quality checks are managed by the Primary Care Support England (PCSE) Registrations team on behalf of NHS England.
The process checks the following six groups:
PCSE compile a separate patient list for each group and send these to either the GP or a letter to the patient directly requesting that the registration details are confirmed. Upon the return of information, PCSE will either:
PCSE is required to carry out routine data quality checks on the patient details it maintains. The request contains details of patients our records show are registered with your practice. Your practice is required to confirm whether or not the details held are accurate. The guidance supplied will help you to complete the information requested. It is important that your practice responds in order to ensure that eligible patients can be contacted for routine screening, and that payments based on patient registration data are accurate.
A ten day period is provided to all GP practices to review the patient data and complete all associated actions, including any required patient deductions. The reason why there is a 10 day limit is that data becomes out of date and so any changes need to be applied quickly.
Once all actions are complete for this patient list data quality check, the PCSE team will make further contact with your practice again to request confirmation of patient registration data for other cohorts of patients. This is in line with the NHS England policy.
An FP69 is a flag that is set on a patient’s registration record when it is believed they no longer live at the registered address. When the flag is set, a message is sent electronically to the GP practice advising them that the details may be incorrect, and asking them to provide a new address, or to confirm if the patient is still living at the address held. GP practices should be contacting patients to establish whether or not they have moved or should be removed from the register. If no response is received from the patient or the GP practice, the patient will be removed from the practice list of patients six months later.
PCSE is notified of demolished properties on a quarterly basis by Royal mail and a FP69 flag has been set because it is believed that the patient no longer lives at the registered address.
If PCSE does not receive a completed spreadsheet, an FP69 flag will be applied to any patients concerned. Notification of these flags will be received through GP links onto your clinical system. The setting of the FP69 flag will give the practice six months to confirm the registration status. To confirm the registration status the practice should add a note to the patient record such as ‘address confirmed’ or ‘seen recently' through GP links. Alternatively, the practice can provide an updated address before the patient is removed from the practice list. If no action is taken this could result in patients being excluded from routine screening programmes.
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.
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
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 email@example.com (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 firstname.lastname@example.org to let us know, and include the following information:
• The name of new care home
• The full postal address of the new care home
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.
Please email email@example.com 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 name
• 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 – if your supplier is system one it should commence with the prefix YGM ….)
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.
Please do not attempt to send any registrations through the GP links until the GP links are turned back on (go live date).
If you have any queries regarding system migration please contact firstname.lastname@example.org
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 foundhere.