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I have 2 adopted children and both of their names were changed after adoption. New NHS cards etc. Speak to your GP - there is something called an 'S flag' that they can apply to their medical records which limits who can see their records (in case birth family work in the NHS).....

Thank you Sarah B, appreciate you replying. I'm probably worrying over nothing but it just worried me. She was ringing from a little playgroup in our area where some of my family members work and I know a lot of the parents and staff; I've not told anyone of our name change aside from my parents and siblings. Just surprised me that they would physically link the two names in one document, seems dangerous to me. We never had NHS cards, just GP registration letters and a new one of those was issued in the new name. Has made me a little paranoid about how they are recording info, all letters I receive from GP or hospital are in new name so has just alarmed me why this should still happen. Will speak to my GP as you advised and am even tempted to do a data access request to see exactly how they are recording information. Thanks again!

Hi T's Mam - when a child is legally adopted, they should be issued with a new NHS number and a completely new record begins from scratch. Their old medical records should be closed down, and there should be no link between the old records and the new ones. Unfortunately, as adoption is a relatively rare thing, it's not unusual for GP surgeries to not be aware of the procedure. What can happen is that when you inform the GP of the adoption and the change of name, they just change the name on the child's original record, meaning that both the old and new names are on there and possible identifying information from their time with birth family is also on the same record so anyone searching the database can see everything, which is far from ideal.

In the old days, pre-digitalisation, what should have happened is that a new NHS no. is generated, and new file is created, and someone, usually a senior HV, will create a written summary of essential information from the child's original notes (vaccination, known health issues, etc.) to be appended to the new file. This document explains the process, and if you're having problems, it might be worth printing off a copy and taking it to your GP, asking if the procedure has been properly followed: https://pcse.england.nhs.uk/media/1247/adoption-medical-records-practice-guide.pdf

Here is a link to some guidance local to Nottinghamshire that details the challenges around digital record keeping, and the processes they have adopted there to ensure this is done properly. https://www.mansfieldandashfieldccg.nhs.uk/media/1941/adoption-managing-child-health-records-for-children-who-have-been-adopted-in-nottinghamshire-county-april-2013.pdf

So, the HV in your case is not correct that records have to follow the child. In the case of adoption, original records absolutely do not follow the child, and it is the responsibility of health professionals to ensure that key information is carried over, but identifying information is redacted so that anyone looking at the new files would not see any reference that could identify birth family by name, location or other identifying feature. This can cause problems where children (like mine) have extensive medical histories before adoption that need to be retained, but it is to preserve anonymity for the adopted person.

This issue comes up so often that it's a wonder that prospective adopters are not more thoroughly prepared during assessment and training - it seems that very few adopters are given proper information about this, perhaps because social workers just assume that the NHS will do its job, but as I, and many others, have found, some prompting is sometimes needed!

Just as an aside for anyone reading this, if you adopted a child in England who had already begun compulsory education and been issued with a unique pupil number, the same process should happen: their old file should be closed, a new unique number created, and a new file created. Again, unaware of the procedures, some schools simply change the child's name on the original file. This can mean that, depending on the settings on their digital files, documents can continue to be automatically generated with the child's birth name printed on them. Parents adopting school age children should consider going down to school and making sure this procedure is being carried out properly.

My goodness Becky thank you SO much for all this. Can I assume from your profile name that you're a member of staff of AdoptionUK? I just want to be able to quote you with some authority.

Am going to have a look at the links you gave after work. Just wanted to check if you know if the situation is any different in Wales?

Am so relieved you've said this as it's really concerned me. I worked in social services for years and know there that records are so much tighter, NOBODY without case responsibility would be able to access both names. Has really concerned me I won't lie.

No worries - yes, I'm Becky Brooks, Education Policy Advisor at Adoption UK. To be honest, I only know so much about this because my daughter has had a load of health needs going on since not long after birth, and as I fostered her before I adopted her I knew the score and put a lot of effort into making sure her medical records would be sorted once she was adopted. Even with all my research and many patient explanations to hospitals, health visitors, the GP, etc. there were still hiccups such as repeat prescriptions not appearing on the new records, a hospital appointment that was cancelled because they didn't recognise her on the system, etc. etc. Some of her tests had to be re-done because the results were not on her records. It was a real pest, so I do understand that some adoptive parents don't really want the new NHS number and all of that but, on the other hand, I don't think many adopted people would want that like a red flag on their medical file every time they go for any appointment - it's for them to share as necessary, not for every health professional to see - and also there's the issue of anonymity. I can't promise it's the same in Wales, to be honest, and I can't find any Welsh-specific information with a quick Google, but I expect it will depend on how devolved the NHS in Wales is - I'm afraid I don't really know. It's possible if you contact the AUK Cymru office by email, or the AUK helpline in Wales, someone there might have the info on the situation in Wales for you. I'm afraid too often those outside of adoption simply cannot grasp how or why these things are important!

Thank you Becky. It's so reassuring to hear that I'm not overreacting with this. Anonymity and safety is my main concern and then, of course, the knowledge of adoption is something my child would share when older if necessary or choice. Will definitely contact Wales branch and hope that they can give clear guidance on it. Thanks again, I will update here if I get some resolution. T x

Just checked NHS No. That's stayed the same, just name changed. Will let you know how we get on.

I’m in Wales - definitely should be a new NHS number. I have their old cards and their new ones - they have different numbers. I did though have to do some chasing. It was a long time ago though. Maybe start with practice manager - but also ask if s/he can get copies of old notes. Ours did.

Thanks Donatella. I'll try and get an appointment with the practice manager then and start from there. I have a bad feeling about all of this though. When my child first came home my social worker advised I would have to register in birth name until adoption order was in place but that we could use a 'known as' name in the interim but that was refused. Eventually got them to agree that I would ring and make appointment for myself and that only when in with doctor would say it was actually for my child. It's always really concerned me how many people could see her old name, particularly when it was being changed because I was being made to do that. I live in a very, very small area in Wales, most of the practice staff either live in my village or went to school with me or my mother. Will give myself a few days so am not feeling so emotional about it and try it then I think. Thanks again.

These things do matter. It is important. These procedures exist for a reason. I really hope the practice manager is not defensive and appreciates the situation. Do let us know how you get on.