The NHS number is a unique 10-digit number allocated to every patient in England, Wales and the Isle of Man, either at birth or when NHS care is accessed for the first time, usually by registering with a GP practice. It is used to help healthcare staff and service providers correctly match an individual to their health record.
NHS numbers are managed within the Personal Demographics Service (PDS), a database of NHS administrative patient information including NHS number, name, address, date of birth and associated non-clinical medical information such as general practice registration details.
They are valid for life except in the cases of adoption, gender reassignment or to protect an individual’s identity. They do not automatically allow access to free healthcare or treatments.
To improve readability and improve communication if the NHS number is read out to a listener, good practice is to write the 10-digit number in three parts with two groups of three digits followed by a group of four digits with a space between each group. The 10 digits alone without any spaces are all that is necessary when entering an NHS number into any electronic system.
Different NHS numbering systems are used in Scotland (Scottish Community Health Index (CHI) number) and Northern Ireland (Northern Ireland Health and Care (H&C) number).
The NHS England web pages (for NHS staff) on the NHS number include a helpful link to information for patients.
Allocation of NHS numbers
The NHS number is usually allocated by a midwife either in hospital or at home, as part of the statutory notification of birth. This includes babies born (live or stillbirths) in a range of different settings, e.g. in an NHS hospital, at home, or to parents in the armed forces.
If not at birth, numbers are allocated:
- on initial registration with a general practice surgery in England or Wales
- on receipt of data from the home office for migrants and visitors who have paid the immigration health surcharge or who fall into an exemption category, e.g.: asylum seekers
Purpose of the NHS number
Delivery of patient care is often shared across several NHS, and non-NHS, providers. The flow of infDelivery of patient care is often shared across several NHS, and non-NHS, providers. The flow of information and records relating to a patient between providers including social care, is effectively linked up using the NHS number.
For this reason, the NHS number should be present in all active patient records and must be identified as early as possible in any episode of care. It is fundamental to patient safety across all care settings by:
- reducing the risk of clinical information being incorrectly identified or recorded in the patient record
- reducing the risk of breach of confidentiality if information about another patient is included in the wrong record
- acting as a unique identifier when accessing digital services, e.g. the NHS App
- overcoming some barriers to the safe sharing of information across healthcare settings
- helping with follow-up patient care, including screening
- reducing the risk of duplicate records being created
- providing an audit trail in the patient record.
The Health and Social Care (Safety and Quality) Act 2015 placed a legal obligation on organisations who commission or provide health care or adult social care, to include a consistent identifier when processing patient and service user information. The consistent identifier adopted is the NHS number.
This act also places a legal obligation on organisations to share information, including the NHS number, whenever possible. For this reason, the NHS number should be present on all patient identifiable communication either electronic or paper. In addition, because the NHS number never changes, it is the most reliable way of identifying a patient, particularly in electronic systems.
Patients should be encouraged to keep a record of their NHS number.
Benefits of using the NHS number in general practice
A summary of the benefits for general practice is available on the NHS England website.
Helping patients find their NHS number
Advice for patients on how to find their NHS number can be found here or via the NHS.UK public facing website.
Patients who have never had an NHS number, should be encouraged to register with a GP practice. This will result in an NHS number being created for them.
Assigning a new NHS number
A patient may be issued with a new NHS number following adoption, gender reassignment or to protect their identity. The newly allocated NHS number will not be linked in any way to the patient’s previous NHS number. Any existing national data opt-out is not transferred automatically to the new patient record.
In these cases, the updated personal information for the patient can be changed in the personal health record at the request of the patient before a new NHS number is provided.
You can read more about adoption and gender reassignment process on the PCSE website.
Troubleshooting
For any issues with NHS numbers including duplication/merged/inactive records with NHS numbers assigned and more, refer to the Primary Care Support England website.