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GP registration digital guide

Learn how GP registration works, and how the various national digital services fit together, including PDS, Register with a GP surgery, GP2GP, PCRM and NHAIS.

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GP registration

All NHS patients in England must be registered with a single GP practice. The GP is their first port of call for healthcare and holds the most detailed care records about them - not just about GP visits but also details of any specialist care received in other care settings.

If a patient wants to change GP, for example because they have moved house, they must register with their new GP, which will de-register them from their old GP.

As part of this process, their full GP record is transferred from the old GP to the new GP, usually electronically.

Geographical scope

Geographical scope

This page describes how GP registrations work in England. Some of the national services involved also cover other regions, such as Wales and the Isle of Man. The process might vary in those regions.

National services

GP registration involves multiple national digital services, as follows:

National service Responsibility Geographical scope
Personal Demographics Service (PDS) Holds the official record of the patient's registered GP England, Wales and Isle of Man
Register with a GP surgery Patient-facing web app for patients to register with a new GP online, instead of having to visit their GP in person England
GP2GP Allows the patient's GP record to be transferred from the old GP to the new GP electronically England
Primary Care Registration Management (PCRM) Manages the formal process to change the patient's registered GP in PDS - new service replacing NHAIS England, Wales and Isle of Man
National Health Application and Infrastructure Services (NHAIS) Manages the formal process to change the patient's registered GP in PDS - old service being replaced by PCRM England, Wales and Isle of Man

Process overview

Process over view the patient registers with a new GP practice the patient's GP record is transferred from their old GP practice to their new GP via GP2GP and the new GP system registers the patient formally using PCRM or NHAIS.

 

At a summary level, GP registration works like this:

  1. The patient registers with their new GP practice.
  2. The patient's GP record is transferred from their old GP to their new GP, via GP2GP.
  3. The new GP system registers the patient formally, using PCRM.

Note: step 2 is bypassed if the old and new GP systems are both TPP SystmOne.

The following sections provide more detail.

1. Patient registers with new GP practice

Patient registers with new GP practice detailed steps described within section 1 patient registers with new GP practice.

 

Detailed steps:

  1. The patient registers with their new GP practice, for example because they have moved house. They might do this in person or via the Register with a GP surgery service.
  2. Regardless of the exact process, during registration, the patient's NHS number will be determined by searching the Personal Demographics Service (PDS).
  3. To find out who the old GP was, the new GP system retrieves the patient's record from PDS. This includes the ODS code for the currently registered GP.
  4. The new GP system updates the patient's registered GP in PDS to be the new GP ODS code.

2. Patient's GP record is transferred

The transfer of the patient record uses the GP2GP service.

2a. New GP system requests GP record from old GP system

Process map showing the detailed steps described in 2a new GP system requests GP record from old GP system.

 

Detailed steps:

  1. The new GP system looks up the GP2GP 'endpoint' for the old GP system on the Spine Directory Service, based on its ODS code.
  2. The new GP system sends a 'GP2GP EHR Extract Request' to the old GP system via GP2GP HL7 V3 secure messaging.

2b. Old GP system sends GP record to new GP system

Process map showing the steps described in 2b old GP system sends GP record to new GP system

 

Detailed steps:

  1. The old GP system prepares the GP record, known as a 'GP2GP EHR Extract'.
  2. The old GP system looks up the GP2GP 'endpoint' for the new GP system on the Spine Directory Service.
  3. The old GP system sends the GP record as a 'GP2GP EHR Extract' message to the new GP system via GP2GP HL7 V3 secure messaging.

2c. New GP system acknowledges receipt of GP record

Process map showing the detailed steps described in 2c new GP system acknowledges receipt of GP record

 

(this step happens in parallel with step 3 below)

Detailed steps:

  1. A healthcare worker at the new GP practices manually reviews the GP record that was received in step 3 above.
  2. If happy, they mark the record as 'filed'.
  3. The new GP system sends a 'positive business acknowledgement' message to the old GP system via GP2GP HL7 V3 secure messaging, indicating an integration state of 'fully integrated'.
  4. The old GP system flags the patient's record to indicate that no paper record transfer is required.

3. New GP system registers patient formally

Process map showing the steps explained in 3. New GP system registers patient formally

 

(this step happens in parallel with step 2c above)

Detailed steps:

  1. The new GP system sends a registration request (known as an 'ACG transaction') to NHAIS or PCRM via the NHAIS GP Links interface.
  2. In some cases this goes to the (legacy) NHAIS system. In some cases it is intercepted by the (newer) PCRM service.
  3. All being well, the receiving system (NHAIS or PCRM) updates the registered GP ODS code in PDS - although this has already been done by the new GP system in step 1 above.
  4. NHAIS or PCRM sends a 'registration acceptance' transaction to the new GP system via NHAIS GP Links.
  5. At the same time, NHAIS or PCRM sends a deduction ('DEF' transaction) to the old GP system via NHAIS GP Links.
  6. The old GP system marks the patient record as 'deducted'.

Last edited: 19 June 2025 12:12 pm