Birmingham GPs say patients barred for incomplete data

GPs in Birmingham claim that four primary care trusts are rejecting patient registrations if their demographic data is incomplete, as a result of the implementation of the NHS Care Records Service.

The city’s local medical committee claim the action by Birmingham’s Shared Services Agency is putting vulnerable patients at risk and leaving practices without the resources to care for them.

However the allegation has been refuted by the four PCTs covered by the city’s shared services agency. A statement issued by the four trusts denies that registrations are being refused but states that the agency is no longer able to allocate temporary NHS numbers because of the implementation of the electronic care record.

The dispute has coincided with an announcement from Connecting for Health that all PCTs in England can now immediately allocate NHS numbers for new patients.

Dr Robert Morley, secretary of Birmingham LMCs, told EHI Primary Care that Birmingham Shared Services Agency had begun rejecting new registrations in the summer.

Dr Morley explained how the problem became apparent: “Practices were finding registrations bounced back to them saying we can’t register this patient with this practice because you haven’t provided us with enough information to immediately allocate an NHS number.”

Dr Morley said the shared services agency then wrote to practices in August informing them that all existing patients on temporary NHS numbers would be removed from registration within three months unless practices could provide further demographic information to enable a permanent NHS number to be allocated.

Dr Morley added: “It’s not up to practices to chase up additional demographic information and it’s in breach of the GMS and PMS regulations not to register patients as soon as possible. We are talking mostly about very vulnerable people here, immigrants and asylum seekers, who will be denied access to full NHS care.”

Dr Morley said the LMC had informed the British Medical Association’s General Practitioner Committee about the agency’s action and it had contacted both the Department of Health and Connecting for Health.

He added: “They said all patients should be allocated an immediate permanent NHS number and if it later turns out to be a duplicate it can be rectified at a later date. We have sent the information that the GPC provided us with onto the agency but have not heard back from them yet.”

A joint statement issued by the four PCTs covered by the shared services agency, Birmingham South, Birmingham East and North, Heart of Birmingham and Solihull PCTs, states: "Birmingham PCTs are not refusing to allow patients whose NHS number is not known at the point of registration to register with GPs.

As part of the implementation of the electronic care record the process for allocating NHS numbers has been changed and the facility to assign temporary numbers no longer exists for PCTs.”

The statement adds that practices will be contacted if the patient cannot be traced from the information provided but claims that new NHS numbers are allocated to patients if the surgery can confirm the information provided by the patient if correct.

The PCTs add: “The cross check with the surgery is done to avoid creating a duplicate record, previously there was an option to allocate a temporary NHS number to the patient while more detailed tracing was done by a central NHS team, this option is no longer available so the onus on tracing the patient at registration is much stronger."

The announcement from CfH on NHS numbers states that all PCTs now have access to the Spine to enable them to allocate an NHS if the patient’s demographic details cannot be found on the Spine.

It adds: "Previously these cases had to be investigated by the Personal Demographics Service National Back Office (PDO NBO) before an NHS Number could be allocated, causing a delay which could in turn delay the patient’s treatment. For example, without an NHS Number, a patient cannot be referred using Choose and Book. Most patients’ demographic details such as name and address are now held on the Spine but in some cases, they cannot be found, for example if someone has recently immigrated to England.

"Over the next few months and years the functionality which has enabled PCTs to allocate NHS Numbers in these cases will be extended to all NHS trusts through their Local Service Provider (LSP) systems."