Registering a birth

Registering a birth is predominantly performed by the Maternity Units, and the following diagram summarises the main steps:

Allocation of the mother’s NHS Number is only carried out when all possible routes to find the mother’s NHS Number or find her record on the PDS have failed. Most mothers will have a record on the PDS and an associated NHS Number.

If the mother is registered with a GP they will already have an NHS Number and an allocation should not be performed. Instead further efforts should be made to find the mother’s PDS record. Section 6 'Searching and allocation advice' contains detailed searching and allocation guidance.

The initial step in the birth notification process is always to trace for the mother. It's important that all efforts are made to find the mother’s PDS record - this will ensure that all the correct details are used and will avoid duplicate records being created. You should take care to ensure that the record selected is for the correct mother. This will avoid the mother’s record becoming confused with another and prevent the baby's details from being linked to the wrong mother.

The 'Find a patient' screen

After accessing the NCRS you will be presented with the 'Find a patient' screen which allows you to find a mother’s PDS record.

Tracing methods

Finding or tracing for a patient on the PDS using an NHS Number is always the best method of finding a unique match to an existing PDS record. Mothers who have been referred from primary care should always be referred for maternity care with their NHS Number. However, an NHS Number may not always be available or known. In these cases other available details, such as name, gender, date of birth and address should be used. The Searching Tips section has further guidance.

If a single PDS record is found for the details entered, then the mother’s demographic details are displayed. If multiple PDS records match the search criteria entered then they will be displayed in a Patient List. From the list you can carefully select the correct mother’s PDS record to be used in the birth notification.

If you're unable to find the mother’s PDS record then alternative searches should be attempted. The Searching Tips section has further guidance.

If you can't find a PDS record for the mother, and you're confident that you've attempted all possible means to find a record, then you can select the Allocate option. This will create a new PDS record for the mother and allocate an NHS Number for them (see 'Allocating an NHS Number for the Mother'). It's also possible to progress to the Birth Notification screen with no mother’s PDS record found and no known NHS Number for the mother - this should only be performed when no record exists and it is not possible to allocate an NHS Number for the mother.

Continue to the birth notification

Confirm mother’s PDS record

When you have confirmed the correct mother’s PDS record the demographic details are displayed for the mother. You can now select the Birth Notification tab to enter the birth notification details. Please note that you will not be able to continue to enter a birth notification if the selected PDS record is:

• not female
• female and under the age of 10 years

No confirmed mother’s PDS record

If you have attempted all possible searches for the mother’s record, but found no matching record, and cannot allocate an NHS Number for the mother, then you should not select any of the returned rows (if any exist). You should instead select the 'Proceed to Birth Notification without Mother’s NHS Number' option by selecting the ‘Birth Notification’ link. This will allow you to complete the birth notification without a mother’s NHS Number.

You can allocate an NHS Number to the mother if you have attempted all possible searches for their record, but no matching record has been found. You should select the Allocate option and proceed to allocate a new NHS Number for the mother.

These allocated details will be passed to the 'Enter Birth Notification' screen.

Mother’s PDS record is incorrect

If you've attempted all possible traces for the mother, and you find a match to a PDS record that is not up-to-date (for example the address details are incorrect or the surname has changed), you should:

• confirm the patient using the old details, 
• correct the details using the NCRS
• select the ‘Birth Notification’ and enter the birth notification details. 

Partial record returned for a mother

If when searching for the mother’s PDS record you discover that only a partial record is returned containing no address details, it means mother’s location details are being protected. The following procedure should be taken:

1. Continue to the Birth Notification tab and enter details of the birth.
2. Request the patient’s address;
   • The address can be verified on entry
   • You can reassure the mother that the details are not stored on the PDS and their PDS record status will not be amended.
3. If the Mother doesn't wish to give their address then enter the address of the maternity ward as the Usual Address and follow local (manual) procedures to inform the child health unit of the mother’s correct address from this point.
4. Complete the Birth Notification.

If you have attempted to search for the mother’s PDS record and are confident that the record does not exist, then you may allocate an NHS Number for the mother.

Remember, you must have tried all possible means of searching to find the mother’s PDS record, and must be confident that no PDS record exists, before performing an allocation for the mother.

You should follow these guidance principles before considering to add a new patient record to the PDS:

1. Most patients will already have a record on the PDS and an NHS Number.
2. Referrals from GPs should have the patient's NHS Number.
3. Most duplicates are created because the patient has not been identified correctly and therefore not traced on the PDS.
4. If there is any doubt about the patient‟s identity don't allocate.
5. Limit the ability to allocate to a very small number of highly trained staff.

Failure to follow these principles will result in the creation of duplicate records on the PDS. This means:

• significant additional work is needed both nationally by the National Back Office and locally, by all organisations that have had contact with the patient, to resolve the duplication 
• a clinical is created risk for the patient - the existence of more than one PDS record means that organisations providing care may not identify the correct health record

The PDS record that is created is not a full PDS record. It contains only the minimal data required to create both a record on the PDS and the birth notification for the baby. 

The Allocate screen

If you want to allocate an NHS Number for a mother then you'll need to enter the mother's:

• surname
• forename
• date of birth
• address - the house name/flat number or house number/street must be entered, plus the postal town
• other names (optional)
• telephone number (optional)

When you have entered the details you select to allocate the NHS Number for the mother, and the NHS Number is returned. Then, control will be passed automatically to the Enter Birth Notification screen.

Defaulted data

The GP practice code will be defaulted to ‘V81997’ (Not Registered). Note that the allocation will not perform the registration at a GP practice.

If the mother has a GP then they will already have an NHS Number and you should not perform an allocation. Instead further efforts should be made to find the mother’s PDS record.

Previous NHS contact

If the person has had previous NHS contact then they may have an NHS Number. If the patient has had previous contact select ‘Yes’.

This screen is used to enter all of the details for the birth notification. It contains details for the mother, the baby, the birth, the place of birth and the notifying person.

Control will be passed here after you have either:

• selected a mother’s PDS record
• allocated an NHS Number for the mother’s PDS record
• ensured that an NHS Number is not required for the mother and continued to the birth notification

The Birth Notification screen

All of the existing birth notification details used in the NHS Number for Babies (NN4B)/Care Identity Service (CIS) system or on Interim NHS Numbering System (INNS) are included here. There are no new details. Fill in the details required, clicking 'Next' to move to the next step.

Some details will be carried forward from the mother’s PDS record. Additional details will be taken from your smartcard in order to minimise the amount of information that you need to enter.

Initial display from Find a Patient or Allocate screens

The table below shows the details that are pre-populated upon entry into this screen.

All other details are blank.

Subsequent display for the same mother

The table below shows the details that are pre-populated upon entry into this screen when entering a subsequent birth for the same mother.

All other details are blank. This option is only available if you are entering a multiple birth (that is - that the Number of Births in Confinement is greater than one).

Duplicate checking

After submitting a birth notification the details are validated. Any errors or omissions will be highlighted. If there are no errors then a birth notification will be submitted to the PDS where a number of checks are performed to ensure that it is not a duplicate.

If the submitted details are similar to an existing birth notification this is classified as a ‘potential duplicate’. A list of these potential matches are displayed to you. You should browse the list of potential matches and confirm that the details you have submitted are unique. If this is the case then re-submit the Birth Notification. The birth notification will be sent to the PDS without further duplicate checks.

If the submitted details are an exact duplicate of an existing birth notification an error message displayed. It is not possible to re-submit an exact match.

After submitting a birth notification a Response screen will be displayed that shows all of the information included in the birth notification and the outcome of the submission.

Failed submission

If an error occurs after submitting a birth notification an error banner will be displayed across the top of the screen indicating why the submission has failed.

The birth notification will be saved to allow you to meet any local business procedures that need to be carried out. The failed submission can be managed in the list birth notifications screen.

Successful submission

After successfully allocating an NHS Number for the birth notification, a response screen is displayed. This displays the baby’s NHS Number and all of the details that have been entered.

A number of options are available following a successful birth notification. These options are:

Printing the birth notification

This option allows you to print the birth notification as part of a discharge notice, or as a means to pass information to child health units in the event of an error or a failure in obtaining an NHS Number for the baby.

These birth notifications can also be used as part of the local process for dual-keying if they are required.

Printing the blood spot labels

The blood spot labels must be attached to the newborn blood spot card. This includes all of the information required when processing the test. The labels can also be used on other physical media, such as printed medical records. There are two types of label; with and without barcoded NHS Numbers for the baby.

Printing identity wristbands

You can print out two identity bracelets for the baby if you have a thermal transfer printer⁵. These bracelets must fastened to the ankle and wrist of the baby to ensure identification.

Entering another birth notification

There are two options here; to enter another birth:

• for the same mother (if the Number of Births in Confinement is greater than 1, such as a multiple birth)
• for a different mother