The Primary Care Registration Management (PCRM) programme represents a pivotal modernisation effort within the NHS, aiming to improve the efficiency, security, and patient-centred approach of primary care registrations. Aire Logic has been a key partner to NHS Digital, and now NHS England since 2018, contributing to the successful development and implementation of PCRM.
PCRM is a back-end service that enables patients to register with a GP practice and access GP services. It provides a way for a patient's GP registration to be co-ordinated amongst the:
- patient's new GP system
- patient's old GP system
- Personal Demographics Service (PDS): a national service that holds the patient's demographic details, including their address and registered GP. Healthcare professionals use PDS as the national master database of all NHS patients in England, Wales and the Isle of Man.
PCRM also:
- allows GP systems to update the patient's address in PDS
- supports the GP payments process by providing details of registered GPs to Primary Care Support England.
The Challenge: Legacy System Limitations
NHS Digital launched the PCRM programme to address significant issues with the legacy system underpinning primary care registrations: the National Health Application and Infrastructure Services (NHAIS). Key challenges included:
- Outdated Technology: NHAIS relied on ageing infrastructure, which was costly to maintain and adapt to new healthcare requirements.
- Inefficient Processes: Manual, cumbersome processes led to delays, errors and frustration for patients and healthcare providers.
- Limited Data Quality: Data inconsistencies hindered accurate reporting and decision-making.
- Lack of Interoperability: NHAIS’s inability to integrate seamlessly with modern healthcare systems created barriers to efficient, connected care.
The solution lay in migrating functionality from NHAIS to Spine (the NHS’s central IT infrastructure) and modernising primary care registration management processes.
What we did
Working as part of a blended team with NHS colleagues, we provided expertise in agile product and delivery management, business analysis, system architecture and development, and collaborated with stakeholders to overcome these challenges.
Collaborative DevOps and agile delivery: We fostered a DevOps approach, ensuring seamless collaboration between development and operations teams to deliver efficiently and smoothly. Embracing agile methodologies, we leveraged iterative development cycles that allowed us to respond rapidly to evolving requirements and drive continuous improvement. Tools like Jira, Confluence, and automated testing frameworks enabled transparent workflows and robust quality assurance. This agile and collaborative environment ensured development efforts remained efficient, adaptive and aligned with NHS needs.
Developing and implementing core components: We played a pivotal role in delivering key functionalities for the programme, transforming core components to enhance system usability and efficiency. Central to this were:
- Improving the Spine Demographic Reporting Service (SDRS) by providing critical insights into patient demographics and registrations.
- Streamlining registration processes for GP practices: by enhancing GP Practice management, we reduced administrative burdens and improved efficiency.
- Developing the FP69 Electronic Referral Process to facilitate smoother communication between GPs and other healthcare providers.
- Delivering a minimal viable product for the Health and Justice Information Service (HJIS) ensuring its functionality could be migrated seamlessly onto Spine. These advancements collectively enhanced the system’s overall functionality and user experience.
Transition and decommissioning of NHAIS: Transitioning from a legacy system of NHAIS’s scale required meticulous planning and execution. We devised migration strategies to transfer functionality and data to Spine while ensuring minimal disruption to healthcare services. Throughout this process, we offered expert support to maintain service continuity and played an integral role in the safe decommissioning of the NHAIS system. This reduced infrastructure overheads and positioned the Spine as the modernised backbone of primary care registration.
System performance optimisation and support: To ensure a seamless user experience, we focused on optimising the system's reliability and performance and provided comprehensive support., including a:
- robust, efficient system capable of meeting the operational demands of healthcare professionals
- dedicated 24/7 support enabling incident management and proactive issue resolution while addressing technical debt from legacy systems. This enhanced stability and reduced ongoing support overheads.
Stakeholder engagement and collaboration: Our collaborative ethos ensured alignment with a range of stakeholders across NHS England, NHS Digital, Primary Care Support England (PCSE) and the National Back Office (NBO). Through workshops, knowledge-sharing sessions and feedback loops, we incorporated stakeholder perspectives into the design and delivery of PCRM components. We also fostered trust and alignment, ensuring we met the diverse requirements of all stakeholders through open communication channels and transparency.
Key Achievements
Our provision of expert skills and knowledge to the PCRM programme have resulted in several transformative outcomes:
- Successful modernisation: The migration from NHAIS to Spine modernised primary care registration, reducing manual tasks from 600,000 to 300,000 monthly and saving 1,300 hours of healthcare staff time per month.
- Enhanced automation: Automation levels increased from 58% to 80%, significantly minimising manual intervention and associated errors.
- Improved data integrity: Mismatches when reconciling GP patient lists to the Personal Demographics Service (PDS) were reduced by 30%, while failed registrations decreased by 83%, dropping from 4% to under 1% year on year.
- Operational efficiencies: Streamlined processes saved an additional 18,000 manual tasks per month for PCS staff and GPs, improving productivity.
- Risk mitigation: More frequent list reconciliation updates reduced clinical risks and generated cost savings for the NHS.
- Improved user experience: Simplified processes and a user-friendly interface enhanced satisfaction for GP practices and NHS staff alike.
Conclusion
Aire Logic’s role in the PCRM programme demonstrates our ability to deliver transformative solutions through technical expertise, agile methodologies, and a commitment to collaboration. By addressing the challenges of the legacy NHAIS system, we’ve helped modernise primary care registration management, improved efficiency, interoperability, and patient experience and saved thousands of hours in staff time per month!
