Orphaned Record Continuity

When a GP practice closes, patients who do not register with another practice become orphaned patients. Their electronic health record (EHR) cannot transfer via GP2GP because the closing practice’s Organisation Data Service (ODS) code is retired.

The Orphaned Record Continuity (ORC) service mitigates this by:

• extracting the patient’s EHR from the closing practice before system shutdown
• storing the record securely in GP2GP message format
• responding to GP2GP requests from a new practice when the patient re-registers

This ensures the EHR remains available for transfer, reducing gaps in clinical history and maintaining continuity of care.

This service is for integrated care board (ICBs) and commissioning support units (CSUs) involved in managing patient records when a GP practice closes or merges.

General enquiries from ICBs, CSUs and GP practices

ICBs and CSUs who need to use the ORC service for a planned GP practice closure can contact the team at [email protected].

GP surgery support (receiving an EHR)

If a GP surgery is receiving an EHR from the ORC service and is experiencing problems, the dedicated support email is: [email protected].

When a GP practice closes or merges with another, in most cases, the ICB teams in coordination with system suppliers (Optum/TPP/Medicus) will move patients to other local practices. When a practice closes, ICBs will provide patients with a limited time to register themselves at another practice or designate an appropriate/approved practice for data migration. Patients who do not re-register in this time will lose their electronic health record (EHR) to date.

Practices should deduct, print and send such records to Primary Care Support England (PCSE) for storage. However, the electronic counterpart of these deducted records remains within the practice system database. Suspended records are the patient records that remain deducted and not re-registered at another practice in England. These can be re-registered via patient re-registration at a new practice. Learn more about suspended record continuity. Any records left at closure that have been deducted become orphaned when the deducting practice's ODS record closes. When a practice's ODS code retires along with it, the capability to transfer the now-orphaned record via GP2GP is no longer available.

ORC securely stores an electronic copy of the patient's record using the standard GP2GP message format. This happens before the practice’s systems close, keeping the record safe and available until the patient registers with a new GP. When a patient with an orphaned record later registers with a new GP practice, a GP2GP request can made to the ORC service, if ORC holds that record. ORC then sends the EHR to the patient's new practice and removes the patient's record from storage.

Who is included in the ORC service?

The service takes EHRs only for patients who:

• were last registered at the closing or merging practice (and that practice participated in the 
• service)
• do not have an active registration at another practice
• are not deceased
• are not flagged as sensitive or invalid

What information is held?

The service usually holds full encoded electronic GP2GP record messages for each patient. Sometimes, attachments (for example, letters) may not transfer electronically and need to be printed and sent to PCSE instead.

ORC can ingest electronic records for deducted patients at point of practice closure or merger. These patient records can be transferred upon re-registration from ORC beyond point of originating practice closure/merger.

This service is strongly recommended for ICBs and CSUs involved in managing patient records when a GP practice closes or merges.

This service is live. 

This is a bronze service, meaning it's available and supported during business hours from 8am to 6pm, Monday to Friday, excluding bank holidays.