Classification: Official
Publication reference: PRN00540

To:

• All GP practices
• Integrated care board:
  • primary care directors
  • GP leads
  • medical directors
• Regional:
  • directors of primary care
  • primary care medical directors

cc.

• Looked after children professionals

Dear colleagues,

Key principles for ensuring continuous health records of adopted children

Managing health records is a vital part of ensuring the care of patients. When a child is adopted and given a new NHS number, their medical records should be merged with the new post-adoptive details where possible across all health records. This is set out in Primary Care Support England’s Medical records for adopted patients practice guide for GPs.

Merging records creates a continuous health record for the child, protecting their health and wellbeing, giving them the same rights to their medical history as all children, supporting better efficiency in the health system.

When ensuring continuous health records for an adopted child, we ask that you follow the key principles:

1. The child’s clinical health records remain intact and continuous after the adoption order has been granted.
2. Only accurate current demographics can be viewed or used by administration personnel, medical professionals or patients/carers.
3. Information governance and data principles must be enhanced to prevent any accidental disclosure of addresses or third-party information contained in the record.
4. Reminders should be used on the record to highlight the sensitivity of the record.
5. The GP remains the Data Controller with regards to the child’s medical record and as such the process of merging records relies on good communication between primary care, the local Looked After Health/Adoption team and other stakeholders, including your local Child Health Information Service team.
6. The use of standard SNOMED CT codes should be universal, in this case:
   • Record contains third-party information (finding), SCTID
   • 888931000000108; Adopted child (person), SCTID: 393547004.
7. Subject access requests must be handled by NHS provider medico-legal teams with advice from the designated looked after child (LAC) professionals and/or adoption medical.

We want areas to be able to share best practice and innovation across practices and ICBs, so please do get in touch with the team at england.safeguarding@nhs.net.

If you have any queries about this letter, please contact england.safeguarding@nhs.net.

We hope these principles are helpful, as we all strive to deliver the very best care across the NHS for adopted children.

Yours sincerely,

Professor Simon Kenny, National Clinical Director for Children and Young, NHS England
Dr Amanda Doyle, National Director for Primary Care and Community Services, NHS England 
Dr Claire Fuller MBBS DRCOG MRCGP, National Medical Director for Primary Care, NHS England