Changing Your NHS Number
We’ve talked a little bit about NHS numbers in another post, but today, let’s get more into why you might want to change your NHS number, and how to make that happen.
Name and Title Changes Vs Changing Gender and NHS Number
Let’s be clear about something first - changing your name and title is different to changing your gender with the NHS. You can ask for your name and title to be changed at any time, but you won’t be given a new NHS number if you do this. It will just be updated on your current record.
You need a Deed Poll to change your name at your GP practice. Titles aren’t legally protected, so, while you’re changing your name, you can also ask the receptionist to update your title at the same time, too.
Why You’d Need a New NHS Number
The only time you’ll need to be given a new NHS number, is if you go to your GP and ask for them to update your gender on the system. As you might do at many different places and organisations.
If you ask to have your gender changed on your GP record, you will automatically be given a new NHS number. They can’t just change your gender on your current record (as nice as that would be).
It’s, unfortunately, not how the system works.
There are rules and guidelines that must be followed. This includes rules set out by the GDPR and PCSE.
‘Gender reassignment’ is protected under the General Data Protection Regulation (GDPR). The GDPR essentially protects your personal data. Some data can be classified as ‘special category data,’ and will be granted extra protection because of this.
Gender identity is classified as special category data, so is given extra protection under the GDPR guidelines.
This means that when you change your gender with the NHS, your old files, and parts of your new file, are put under higher levels of protection. Doing so prevents people who don’t have higher levels of clearance from seeing the restricted parts of your file, such as any references to your old name and gender.
Here’s more on how the system works, via PCSE:
Official PCSE Guidelines
The requirements of the system are that a gender change means a new NHS number, and therefore, you’d have to be taken off the system and re-registered as a new patient, under a new number.
Side note – changing your NHS number and gender means that, if you’re on hormones, then any blood tests to measure your levels should be measured against the right range for the right gender. But only if you go through the process of getting your NHS number and gender changed.
This is a good thing, because it means that your results won’t keep getting pulled up as ‘wrong’ or inaccurate if, for example, you’re on testosterone but still registered as female on the system.
Sex-Based Medical Screenings
If you manage to go through the process of getting a new NHS number, which we’ll get into in a second, then this means that you won’t be invited to certain sex-based screenings in the future.
This is different for anyone changing their CHI number, which is the equivalent to an NHS number, but specific to Scotland.
Changing your CHI number after the 14th of June 2015 means that you will be invited to the appropriate medical screening. (Information provided in a comment by user Neat-Bill-9229 from this post on r/transgenderUK on Reddit.)
For the rest of the UK, you won’t be invited to sex-based medical screenings.
This isn’t me trying to convince you not to get your gender and NHS number changed.
It’s just important for you to know that if you do change it, then you’ll have to remember to ask for certain medical screenings yourself. This might include a smear test for those AFAB, or to check for things like prostate cancer for anyone AMAB, for example.
Or any number of other routine tests the NHS has to offer.
It’s not fun to have to think about these things, but you should get checked for them once you reach the appropriate age to make sure that your health is always as good as it can possibly be.
The Process
Now that we’ve covered the ‘why’ of changing your NHS number, we’ll finally get into the ‘how.’
You have to go to your GP practise, and tell them that you want your gender updated on the system.
If you ask your GP to update your gender, they should also tell you that they have to change your NHS number by giving you a brand new one.
Or CHI number, if you’re in Scotland.
CHI numbers are 10 digits long, and the 9th digit is based on biological sex. Even numbers mean female, and odd numbers mean male.
Here’s more information on changing your CHI number, where all links on CHI numbers in this guide have been provided by Neat-Bill-9229, underneath this post made by DMC on Reddit.
Changing your CHI number works the same as changing your NHS number, which is detailed below.
Once the process begins, it can take up to 20 weeks.
It used to only take around a month, and in a perfect world, it’s only supposed to take 5 days. But some practices are unfamiliar with having to go through this process, so sometimes it can take longer than it legally should.
There are also other delays due to COVID, as well as there often being other patients also waiting for their details to be changed for various reasons.
Your original record, with your old NHS number, should not be updated. It should be left as it is and eventually deactivated, whereas your new number and record should also eventually be made live. Once all the necessary changes have been completed.
Important – your old record and NHS number should also be restricted so that nobody has access to them, and so that they can’t see your old name and gender anywhere on the system.
Your old record should be sent to your GP with new details, including your name, title, and gender, if those are what you have asked to be changed.
Your GP will then have to transfer all of these old records into your new file, under your new NHS number.
They’ll have to redact any mentions of your old name, gender, and NHS number. Any electronic notes are printed off, redacted where they need to be, and then re-scanned back onto the system, under your new number.
Essentially, all you need to do is ask them to update your gender, plus your name and title if you have a Deed Poll and want everything changed at the same time, and they should do the rest.
Although, it’s also a good idea to check in with them once they’ve agreed to start the process. This ensures that you know that they’ve done everything they said they would.
Complaining About Inadequate Care
Unfortunately, a lot of GPs can get this process wrong. If they do, you’re well within your rights to complain if you know you’ve been given inadequate care.
There are a few ways to complain about poor care, as well as different levels of complaints.
You can talk to the Practice Manager over the phone if you feel like the issue doesn’t need to be escalated any further, and can be sorted out on the same day.
You can make a formal complaint to the practice.
Alternatively, you can complain to NHS England.
If you complain to either the GP practice or NHS England, but still feel like the situation hasn’t been resolved, you can complain to the Parliamentary and Health Service Ombudsman. However, there is a delay of several months because services are under more pressure and higher demand, creating a backlog of complaints that are taking longer to resolve. It is still worth complaining if you feel like the situation requires it.
You can also complain about data protection issues to ICO. They describe themselves as ‘The UK’s independent authority set up to uphold information rights in the public interest, promoting openness by public bodies and data privacy for individuals.’
Clearly, there are a lot of good options when it comes to complaining about care. It’s also advisable to complain within a short timeframe of the issue occurring. This means that you have more time to sort out the issue quickly and effectively, before it has a chance to escalate or get any worse than it already is.
Common Problems/Questions
Like we’ve just talked about – GPs can get things wrong. Especially trans healthcare. To counteract that, here’s a list of problems that people tend to run into, and how you can try to fix them.
1. Your COVID vaccination status isn’t recognised – Another way of saying that your vaccination records haven’t been carried over.
To avoid this altogether, when your GP says they’re giving you a new number, ask them to make sure they re-register your COVID vaccinations on NIMS.
NIMS stands for National Immunisation Management System and, I assume, does what it says on the tin. (Fix for this issue found in a comment on this post, from r/transgenderUK on Reddit.)
2. Asking for a title and/or name change as well as gender – This shouldn’t take as long as it takes to get a new NHS number. If your GP/receptionist says that it can’t be done, they’re wrong, and may be incorrectly assuming that what you’re asking them to do requires a new NHS number.
Getting your title and name changed at your GP is a separate thing and has nothing to do with your NHS number.
To fix this, you might just have to tell them that they’re wrong, and show them the guidance yourself. All they have to do is update your name and title in the system, using your Deed Poll.
3. Your new name and title reverted back to your deadname and old title – That’s because changing your name and title isn’t the same as changing gender and getting a new NHS number. To fix this, you’ll have to go through the above process of getting a new NHS number and changing your gender, name, and title together.
A new NHS number ensures that your name and title can’t revert back to what they originally were. Just ask your GP to change all three, which means you’ll need your Deed Poll if you’re getting them to change your name, too.
4. Other people have managed to change their gender without getting a new NHS number, what gives? – This seems to just be something that happens at GPs that don’t follow the guidelines.
The PCSE guidelines state that to change your gender with the NHS, you must also be given a new NHS number. Keeping the same NHS number means that any records with your old name, title and gender probably haven’t been updated.
This means that you’re more likely to get deadnamed and misgendered in things like official correspondence, such as letters from your GP, for example.
Keeping the same NHS number also means that your records aren’t restricted. Therefore, you lose any privacy you get with a new NHS number, where certain parts of your records are redacted to those with high enough clearance.
Fixing all of this just involves asking for a gender change and therefore a new NHS number at your GP Practise.
5. You’re not sure if your old records have been transferred over to your new NHS number – Call up and ask your GP or the receptionist to find out. But you have to ask pretty quickly, within 5 days of having asked them to change your gender/NHS number.
Otherwise, old records from when you were younger, such as vaccinations, prescriptions, etc, can be lost to time.
Obviously, this can be disastrous for a lot of people who have pre-existing, ongoing health issues. So, make sure to check in with your GP practise, and definitely chase them up on this if they say they haven’t done it yet.
(Spoilers, I’m talking from experience! I’m not sure that my GP practise did transfer all of my old records over to my new NHS number, but I got that changed years ago, so I doubt I’d be able to do anything about that now anyway.)
6. Will changing my NHS number impact my place on the GIC waiting list? – It shouldn’t! But just to be sure, you should call or email the GIC you’re being referred to, and tell them that you’ve updated your NHS number.
This means that they’ll have the right records on you, making it easier to contact you, as well as find any information they might need in the future. If you call them, then you’ll probably have to read out your new number, so have that to hand if you can.
If you’re emailing them, then include both your old NHS number and new NHS number in your email, as well as your full name.
These changes might not always make it into every NHS system, as there are several of them across different NHS sites. This includes places like the Dentists, for example, where you might have to tell them separately.
So, for now, that should be everything you need to be able to navigate changing your title, name, and gender all at the same time at your GP, where changing your gender will result in a new NHS number.
