NHS England » The NHS number

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).

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 an NHS Trust hospital
in a non-NHS hospital
at home
to overseas parents
to parent(s) in the armed forces
in England or Wales but normally resident in Scotland or Northern Ireland
who are adopted at birth

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:
victims of modern slavery
victims of domestic violence
victims of sex trafficking
asylum seekers
to those retaining rights under the European Union Settlement Scheme who had not previously interacted with the NHS and so did not already hold an NHS number
to patients referred for secondary care in England or Wales from the home countries or Channel Islands
to patients in secure residential accommodation.

Purpose of the NHS number

Delivery 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

In general practice the NHS number will:

accurately link the patient to their record
allow patients to access their medical record via the NHS App
help to resolve common demographic issues such as incorrect spelling of patient names, first and second name reversal, name changes or change of address where the patient has failed to inform their practice, etc.
allow care professionals to retrieve key information about patients using a consistent identifier
overcome any confusion on handwritten documents where the handwriting is not clear
enable transfer of patient records electronically using GP2GP
enable referrals using the NHS e-Referral Service (eRS)
help the Electronic Prescription Service (EPS) to send electronic prescriptions from GP surgeries to pharmacies
identify patients in all contact with other health and social care providers
enable patient information to be shared safely within and across organisational boundaries
support research and planning
support interoperability and secure record sharing.

Helping patients find their NHS number

As well as being included in a patient’s GP clinical record, a patient can find their NHS number:

in most documents or letters sent by the NHS, for example, prescriptions, test results and hospital letters
by logging into the NHS App
by logging into patient facing services (PFS) offered by their general practice
by searching online using the Find your NHS number service
by contacting their GP surgery.

Patients used to be given a medical card which contained their NHS number. These are no longer issued and if lost, do not need to be replaced.

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.

Promoting the importance of knowing your NHS number

General practice can help to build awareness of the importance of patients knowing their NHS number by:

including the NHS number in all patient correspondence
placing information on the practice website about the importance of the NHS number and linking to the national service to help patients find their number
providing patients with a printed note of their NHS number if requested.

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 National Back Office (NBO), part of the NHS Digital (NHS Digital became part of NHS England on 1 February 2023).

Summary

A unique NHS number is given to people in England, Wales, and the Isle of Man at birth or soon after; and to anyone who does not have one, at their first contact with primary care.
NHS numbers are considered personal data as they can be used to identify individuals.
Patients do not need to know their NHS number to access GP or other health services.
From a GP practice perspective, the NHS number has a range of benefits, including:
- being able to share information securely between other health and care providers
- ease of access in the use of digital enablers like the electronic prescription service, GP2GP and e-referrals.

Other helpful resources

NHS.UK, Your health records
NHS Digital, NHS e-Referral service (e-RS)
NHS Digital, Electronic prescription service
Cohort and Longitudinal Studies Enhancement Resources (Closer), NHS numbers and the system used to manage them

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