Confusions
What should I do if I have one record with one NHS number, but two people registered at our practice with the same name?
If you need to notify us of any duplicates or confusions cases, please use our dedicated, secure Duplicates and Confusions online form - choose Patient Registrations as the category and Duplicates and Confusions as the type.
What is a confusion?
A confusion occurs when two or more patients are mistakenly linked to the same NHS number in the Personal Demographics Service (PDS). This can lead to:
- Incorrect treatment or medication
- Combined or misdirected medical records
- Exclusion from screening programmes
- Data breaches and confidentiality violations
- Clinical decisions based on inaccurate information.
Confusions are considered a serious data quality issue and a risk to patient safety.
What are the timescales to resolve a confusion?
Typical resolution time: 10 weeks. However, this is largely dependent on the National Back Office’s (NBO) timelines and the speed of responses from practices involved.
The process involves multiple steps and third parties:
- PCSE will need to contact all the practices involved in the confusion and await a response from them.
- In order to confirm the correct information practice(s) may be required to contact their patient directly.
- Once PCSE are satisfied enough information has been gathered a case is logged with the NBO to resolve the confusion on the PDS (Spine).
- The NBO may need to contact the Home Office to verify information if the confusion involves an immigrant patient.
- The NBO investigates and corrects the PDS (Spine) for all patients involved and notifies PCSE.
- PCSE will contact all practices involved with a request to examine and correct the patient records. There may also be a request to re-register the patient or register the patient with a new NHS number.
How do I prevent causing / creating a confusion?
Always verify patient details carefully during registration:
- Full name (including middle names)
- Date of birth
- Previous addresses and GP details
- Date of entry into the UK (If they are from abroad)
We are not sure if we have a patient confusion, how do we notify PCSE?
- A confusion is only when two patients share the same NHS number on PDS (Spine).
- If the issue is demographic (e.g., wrong DOB or address on the PDS) but NHS numbers are correct, it is not a confusion—it is a data quality error. In this scenario please submit a New Patient Registrations Enquiry in the contact us section on the PCSE Website.
- Filling in the confusion form when no confusion has occurred will cause a delay in your query being answered.
- If you are unsure which category your query relates to please submit a New Patient Registrations Enquiry in the contact us section on the PCSE Website.
How do I notify PCSE of a patient confusion?
- Complete the 'New Duplicates and Confusions Enquiry' form on the PCSE Contact Us page.
- Provide as much detail as possible (previous addresses, names, place of birth).
- PCSE can only send patient identifiable information to staff members who are verified contacts at the practice on PCSE online.
What should I do if I have one record with one NHS number, but two people registered at our practice with the same name?
- Gather full details (DOB, previous addresses, GP history) and submit via the Duplicates and Confusions form on the PCSE Contact Us page.
- PCSE will confirm if it is a confusion or a duplicate.
How do I request an update for a confusion case?
Please refer to the timescale guidance before requesting an update.
- Click here to go to the Duplicates and Confusions Contact us page and select 'Existing Duplicates and Confusions enquiry'.
- Include the CAS reference number in your submission.
- Ensure you respond promptly to any PCSE or NBO requests for additional information (e.g., previous addresses, names, place of birth).
How do I handle the medical records of a patient that has been involved in a confusion?
Electronic records:
- Ensure that the clinical system record holds the correct NHS number.
- Remove any notes belonging to the other patient.
- Any clinical information that relates to the other patient(s) involved in the confusion should be returned to PCSE.
- Please contact your clinical system supplier for assistance on how to action the above steps if required.
Physical records:
- Any printed notes belonging to the other patient should be placed in a Lloyd George envelope.
- Request a label via PCSE Online and forward the envelope via the ‘Not my record’ section of PCSE online. Take a look at the Medical Record Tracking Labels video on the PCSE YouTube channel.
Impact of clinical information present in the incorrect medical record:
- Breach of confidentiality.
- Clinical risk due to incorrect information (e.g. Test results held against an incorrect patients record)
- Incorrect treatment delivered.
- Potential regulatory consequences for the practice.