Category: NHS / Healthcare IT Target audience: GP practice managers, EMIS users, NHS smartcard holders, anyone supporting EMIS at a primary-care site
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You try to open EMIS with your smartcard and get an error along the lines of “Smartcard is not synchronised”. Nothing else you try — reinserting the card, reboot, retry — clears it. The card itself works fine in other clinical systems, and your PIN is definitely right.
This is a fixable, well-understood problem, and you can usually clear it yourself in under two minutes without waiting on IT support. Here’s how.
What’s actually happening
Your NHS smartcard identifies who you are. EMIS keeps its own copy of your account, tied to a manual username and password separate from the card. The sync between the two can drift — usually after a card renewal, a password change, or a period away from EMIS — and until you re-sync them, EMIS won’t accept the card as a valid login route.
The fix is to sign in without the card, using your manual EMIS username and password, and then push a re-sync from inside the app. Once done, the card works again on the next attempt.
The fix, step by step
- On the EMIS login screen, choose the manual login option (username + password) rather than the smartcard prompt.
- Sign in with your EMIS manual username and EMIS manual password.
- Once you’re inside EMIS, look at the banner at the very top of the screen when signed in.
- Click “Synchronise smartcard” on that banner.
- Sign out of EMIS.
- Sign back in with your smartcard as normal — it should now be accepted.
That’s it. The sync is a one-shot correction; you don’t need to do it again unless the error recurs.
If you can’t find your manual login
Your manual EMIS credentials would have been emailed to you when you were first set up on EMIS at your practice. Check your NHS.net email address for the original setup message — search for “EMIS” or the sender your practice IT contact used. It’s normally still there because NHS.net doesn’t auto-purge old mail.
If you genuinely can’t find them (mailbox rotated, account was reset, you’re a locum who wasn’t given them clearly), your practice manager should have a record. Failing that, they can request a reset through the practice’s usual EMIS support channel.
What to do if the fix doesn’t work
If you’ve signed in manually, clicked “Synchronise smartcard”, signed out, and the smartcard is still failing on the next attempt, there are three common wider causes worth ruling out:
- Smartcard middleware needs an update — a separate issue, usually presents as PIN-rejected-when-signing rather than not-synchronised. See our guide on NHS smartcard PIN works to sign in but not to sign prescriptions for that class of fix.
- Certificate on the card has expired — check the Smartcard Manager (Care Identity Service / CIS) for the certificate status.
- The card itself has been revoked — rare but happens after a suspected compromise; you’ll need to contact your local Registration Authority for a reissue.
A note on time pressure
We know this error tends to hit at exactly the wrong moment — start of clinic, prescription queue building, phone ringing. The manual-login-then-resync fix is deliberately quick because that’s what the situation needs. Whenever you have a spare five minutes later, it’s worth taking a note of your manual EMIS login somewhere sensible so the next time this happens you’re not hunting for it under pressure.
If you’d like a hand setting that up, or if this error is coming back repeatedly on the same account, drop us a line and we’ll take a look at what’s causing the drift.
