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NHS England

An innovative approach to re-registration saves millions while improving care outcomes

Across England, the NHS moves thousands of patient records between practices and trusts every day. When a patient moves away from a GP practice without registering at a new one, their records don’t have a new destination to go to. These are what the NHS refers to as ‘suspended records’.


Every year, around 600,000 records become suspended. When they do, they have to be retained in a secure location in case the patient re-registers with a new GP practice in the future. 


After partnering with Thoughtworks to optimize its GP2GP transfer service, NHS Digital (now part of NHS England) began exploring opportunities to digitize and improve speed and efficiency for suspended patient re-registrations. NHS Digital was keen to ensure a continuous electronic health record, removing the need for any manual printing and storage. Once again, NHS Digital chose Thoughtworks as the partner to bring their vision of a faster, leaner suspended records process to life.


Using product strategy to identify the best possible solution


The initial scope of the project — as defined by NHS Digital and NHS England — was to create a new solution that would enable the digital storage and transfer of patient records when a patient becomes suspended.


By applying an outcome-based product strategy during our collaborative discovery and exploration sessions, Thoughtworks and NHS Digital teams quickly identified a different path forward to yield faster outcomes for the healthcare system, its practitioners and patients.


Together, we hypothesized that rather than building a new digital version of the current process, it would be more effective to extend the existing GP2GP transfer system to support the movement of suspended records.


“Because we’re both focused on outcomes, we were able to collaborate easily with the NHS Digital team and come up with the best possible solution to their challenges” said Thoughtworks Product Strategist Andy Topham.

Key estimated results year-on-year:

£4.7 million
saving in practice hours
57,000 GP hours
saved by reducing self-reporting
administrative hours saved
Time to access
reactivated records cut from 8 weeks to seconds

With more time for GPs and practice staff to focus on care delivery, the new suspended record continuity service is helping to improve experiences for patients across England.

Empowering practice staff and accelerating care delivery for all

We quickly built a Minimum Viable Product (MVP) version of the solution, and worked closely with GP practices to demonstrate its value in live care environments. That testing enabled us to rapidly prepare it for rollout across England — delivering it in a matter of months.


The suspended record continuity service went live across the whole of the NHS in England simultaneously, enabling the near-instant transfer of suspended records for everyone. 


With the new service in place, re-registering GP practices can immediately access and start using electronic patient records, without having to manually process or re-enter them. Across England, 287,000 patient records are re-registered every year, which is estimated to save around £4.7 million in administrative and GP hours.


For GP practice staff, the system has had a major impact on their working lives. Instead of manually entering re-registrations, they can increase the number of patients served each day, and focus on value add activities, like care delivery. Annually, more than 181,000 hours of administrative time can be reallocated.


Since GPs now have rapid access to re-registered suspended records, they no longer need to spend time conducting self-reporting medical history appointments, where new patients walk them through their care and health histories. By reducing the need for those appointments, the service has helped save around 57,000 GP hours across England, and enabled GPs to start delivering precise, informed patient care to them almost immediately.


With more time for GPs and practice staff to focus on care delivery, the new suspended record continuity service is helping to improve experiences for patients across England, and driving NHS England towards its overarching goal of building an NHS that’s fit for the future. 


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