Information contained within a patient's demographic record is available to authorised users in NHS and associated organisations where:

• They are authorised to use the system
• They have located the patient using their demographics details or NHS Number
• There is a business reason for doing so
• Guidance on managing access to the PDS (PDF 217Kb) outlining what local health communities should do to prevent, monitor and take action if NHS staff, GPs or GP practice staff use IT systems and services to inappropriately view a patient's demographic information is now available to download.

Access to demographic records can be limited when a patient requests that access to information about their location is restricted. Examples of these circumstances may be:

Adoptions

The General Register Office (GRO) for England and Wales (a section of the UK Identity & Passport Service) maintains a record of adoptions made on the authority of Courts in England and Wales in the Adopted Children Register. It is from this Register that adoption certificates are issued.

The GRO notifies the Personal Demographics Service (PDS) National Back Office (NBO) of the adoption.

A new record on the PDS is created by allocating a new NHS Number for the patient. The newly created PDS record contains only the post adoptive details, and replaces the patient's original PDS record. There must be no link between the patient's pre and post adoptive details.

Locally, the Adoptions Agency involved should ensure that the relevant GP/primary care trust is informed so that the GP can be provided with a summary of the patient's medical history.

Gender Reassignment and updates to PDS

Patients who have changed gender gain legal recognition with the issue of a full Gender Recognition Certificate. This will then allow PDS data to be updated.

When a patient requests a gender reassignment the patient's GP or Primary Care Trust must write to the Personal Demographics Service (PDS) National Back Office. The case will then be managed by them.

The National Back Office creates a new identity with a new NHS Number and requests the records held by the patient's GP. These records are then transferred to the new identity and forwarded to thegender GP.

The old NHS Number is withdrawn so that it can no longer be used. Questions on the process should be referred to the patient's Primary Care Trust.

Other Vulnerable Patients

There are a small number of patients who feel that the existence of a database containing their contact details may place them at increased risk and may want to have details within their records restricted and flagged.

It is important for healthcare staff who are approached with requests for a patient's record to be flagged to understand and communicate to patients that flagging a record should not be undertaken lightly, because of the potentially significant impact on the ability of the NHS to deliver joined-up healthcare.

Flagging a record as 'sensitive' will mean that local NHS IT systems will be unable to retrieve your address, telecomms details, registered GP Practice and alternative contacts (such as next of kin) from the PDS. The information will still be held nationally, however.

As a patient, if you require your record flagged you should contact your GP. Similarly, if you wish to have a flag removed from your record this should be done through your GP. Further information for healthcare professionals is available on the NHS CFH nww site (N3 connection required).

Armed forces and MOD

• Current and former Armed forces personnel and service dependents