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Registration authorities and smartcards

Smartcards and access control are secure measures by which clinical and personal information is accessed by only those that have a valid reason to do so.

To be issued with an NHS smartcard, health professionals and NHS staff must have their identity verified to NHS Employers' identity check standards.

Local registration authority managers will find it useful to refer to the National Registration Authority Policy.

Care Identity Service users will find it useful to refer to the Registration Authorities Operational and Process Guidance.

Registration authorities

A registration authority is a function, usually within a NHS organisation, that carries out the identity checks of prospective smartcard users and assigns an appropriate access profile to the health professional's role as approved by the employing organisation.

Smartcards are required to access NHS Spine information systems and registration authorities roles and responsibilities are defined by NHS policy.

Care Identity Service

The Care Identity Service is an electronic system for registering and issuing smartcards. Registration authorities use the Care Identity Service to control NHS smartcard access for the NHS Spine's 800,000+ smartcard users. It’s a unified application that provides a single location for all registration authority activities.


NHS smartcards are similar to chip and PIN bank cards and enable healthcare professionals to access clinical and personal information appropriate to their role.

A smartcard used in conjunction with a passcode, known only to the smartcard holder, gives secure and auditable access to national and local Spine enabled health record systems.

Exceptional demand for smartcards and readers due to coronavirus (COVID-19)

We are working to supply the NHS with additional smartcards and smartcard readers to support the response to coronavirus (COVID-19), including globally sourcing new stock.


We have received requests for 6 months worth of stock in the last 2 weeks.


You should repurpose and use existing equipment you already have, for example existing smartcard readers and keyboards with inbuilt readers, wherever possible.


We will continue to challenge every order and request justification so that we can manage demand and support fair distribution across the NHS.

Registration authority support teams with an account on the Oberthur portal can order a supply of smartcards, and readers can be ordered directly from NHS Digital.

Individual card users should contact their local registration authority teams.

Find contact details for primary care service provider organisations.

How are records protected?

The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS and what controls patients can have over this. It covers:

  • people's access to their own records
  • controls on others' access (such as carers)
  • how access will be monitored and policed
  • options people have to further limit access
  • access in an emergency
  • what happens when someone cannot make decisions for themselves

Everyone who works for the NHS or for organisations delivering services under contract to the NHS has to comply with this guarantee. It was first published in 2005 and is subject to regular review, ensuring it remains clear and continues to reflect the law and best practice.

Find out more about registration authorities and smartcards

National Registration Authority Policy

Operations and Process Guidance

Further information

  1. internal

    Care Identity Service

    Find forms, guidance leaflets, and the latest news and updates related to the Care Identity Service.

  2. internal

    Smartcard printers

    Find out about ordering printer materials and additional printers, along with how to report printer problems.

  3. external
Last edited: 12 October 2020 1:06 pm