Understanding the NHS Single Patient Record | What Primary Care Leaders Need to Know

2 days ago
8 min read

At THC Primary Care, we create resources to support the leadership and management of primary care networks, and the focus of this blog is data.

I recently attended the OpenEHR Conference in Barcelona, where healthcare leaders from around the world gathered to explore the future of digital health.

(OpenEHR is an open standard for storing and structuring health data. Think of it as a common language that allows different IT systems to share information seamlessly.)

One message stood out: healthcare's future depends not just on collecting data, but on sharing it safely and intelligently, and this is a global problem.

Whether you're running a PCN, leading digital transformation, or managing integrated services, this guide will explain what the next phase of NHS data sharing actually means for you and what you can do now, whilst the national infrastructure is being built.

In This Guide:

Where We Are Now: Shared Care Records have transformed local care, but the data stops at ICS boundaries. When your patients move temporarily between areas, their information doesn't follow them.

The Building Blocks: OpenEHR, SNOMED CT, and GP Connect sound technical, but they're the foundations that will determine whether data sharing works or becomes another failed IT project. I'll explain them simply.

The 2028 Vision: The Single Patient Record isn't just about connecting systems. It's about patients genuinely controlling their data through the NHS App, whilst clinicians access a unified record that finally includes pharmacy, social care, and community services — not just hospitals and GPs.

Why This Matters to You

In a recent webinar with GPs, the same issues kept coming up — problems that every NHS leader will recognise. These aren't abstract technical challenges. They're real workflow issues that cost time, create risks, and frustrate staff:

Radiology cancellations: GPs receiving 50 cancelled radiology appointments at once from secondary care, with no proper notice. Each one needs processing, patients need contacting, and appointments need rebooking.

Third-party laboratory issues: When pathology services are outsourced, systemic problems emerge. Incorrect blood results, reference ranges changing without proper notice to GPs, and patient results getting mixed up. In one case, two different HbA1c results for the same patient, with one actually belonging to someone else.

The accountability gap: Laboratory contracts with no mechanisms to penalise providers for mistakes or poor performance, despite hundreds of incidents being reported. No contractual levers to enforce standards.

These aren't purely data problems. They're data + communication + accountability problems, and this is why data sharing standards, governance, and accountability frameworks all matter.

A good data infrastructure should include automated notifications, structured workflows, and contractual mechanisms to ensure quality. Without all three elements working together, you get exactly the problems described above.

Why Data Sharing Matters for Neighbourhood Health

At its heart, the neighbourhood model is about bringing services together. GP practices, community providers, mental health teams, social care, and voluntary organisations to care for local populations.

For this joined-up approach to work, every professional involved needs to see the same accurate information about the patient, in real time. That's what data sharing enables: safer decisions, fewer delays, and less duplication.

Progress is being made (Even if it doesn't feel like it)

Most areas now have a Shared Care Record. In Kent and Medway, for example, the KMCR brings together data from GP practices, hospitals, community services, and local councils.

Clinicians can see the same medication lists, test results, or care plans, and patients themselves can view much of their own information directly through the NHS App.

For the first time, patients can open the NHS App and see their own records, test results, and prescriptions, putting them at the centre of the data-sharing ecosystem.

Shared Care Records Across England

Every Integrated Care System (ICS) in England now has a Shared Care Record (ShCR) in place. A secure digital summary bringing together information from GP practices, hospitals, community services, and social care.

However, the maturity and scope vary from region to region. Some areas, like Kent & Medway, Greater Manchester, and Dorset, have advanced systems connecting a wide range of partners, including pharmacies and hospices. Others are still developing, linking primarily GP and hospital data.

Access is expanding gradually. Clinicians across most settings can already view records, but pharmacy and voluntary-sector access is still rolling out. Not every area can use it to its full potential..... yet.

The UK's Perspective

I know many feel the frustrations of our health and care system personally and professionally on a daily basis. However, the UK has made huge strides in building a connected health system, unlike, for example, Germany, where there is not yet a single national health identifier that links every patient's records across the system.

In England, by contrast, every person has a unique NHS Number. A lifelong identifier used across GP practices, hospitals, pharmacies, and community services. It's this consistent digital identity that underpins the NHS App, Shared Care Records, and the next phase of integration through GP Connect.

The future of healthcare depends not just on collecting information, but on how safely and intelligently we share it.

Where Neighbourhood Data Sharing Works — and Where It Doesn't

Neighbourhood working will succeed when relationships are strong and information flows reliably.

Many providers like community trusts, mental health services work across several neighbourhoods, serving 250,000+ patients with multiple hospitals involved.

This complexity is exactly why data standards, communication, processes, and accountability matter: your patients' information needs to flow seamlessly regardless of which systems different organisations use.

But an example of where this model breaks down is when patients move temporarily between areas. The data-sharing architecture works well locally but remains fragile nationally. A reminder that while we've made progress, the journey to truly portable health data continues.

Imagine a future where:

You attend an urgent-care centre while visiting family in another county, and the clinician can immediately see your medication history.
Your pharmacist can update your GP record wherever you are in the country.
You, as the patient, can see the same data on your phone and you choose who else can see it too.

That's the direction of travel, and it's both ambitious and achievable if we maintain a shared commitment to open standards, trust, and transparency.

The Technical Building Blocks:

I wanted to include this infographic to help paint a picture of what the technical elements are that need to happen.

This is no small feat.

With legacy systems to build upon and millions of pounds required, everything needs to align.

The finances need to stack up, organisations need to agree, compromise, and work together, and functionality needs to be world-class.

NHS data flow infographic with architecture layers: vocabulary, clinical model, exchange, governance; and 2025 status updates.

The NHS 10-Year Plan and the Single Patient Record

The NHS 10-Year Health Plan reinforces this ambition, setting out a commitment to create a Single Patient Record (SPR) for every person in England. Not to be confused by the Shared Care Record (ShCR).

The goal is simple but transformative: one secure, authoritative record that combines information from GP practices, hospitals, community services, pharmacies, and social care — and that both clinicians and patients can access.

To make this happen, new legislation will place a duty on every health and care provider to make patient information available to the patient.

The Maternity Care Rollout

The Single Patient Record will roll out in maternity care first — addressing mothers' repeated frustrations about having to retell their story and having their preferences ignored.

This will ensure maternity teams have complete information about previous consultations, medical history, and stated preferences, helping them provide genuinely high-quality, personalised care.

Patient Control and the Redesigned Opt-Out System

Patients will have genuine control over who sees their data through a redesigned opt-out system, informed by public engagement.

The plan commits that by 2028, patients will be able to set access restrictions and see who has viewed their records — similar to Estonia's system, where patients can view who has accessed their data and set restrictions on specific information.

Linking Community Pharmacy to the Single Patient Record

The plan explicitly commits to linking community pharmacies to the Single Patient Record, meaning pharmacists won't just update GP records via GP Connect — they'll access the same unified record that includes hospital, social care, and community service data.

This represents a fundamental shift in how pharmaceutical care integrates with the wider health system.

The IHO Vision: Integrated Health Organisations

Looking further ahead, the plan creates a pathway for the very best NHS Foundation Trusts to become Integrated Health Organisations (IHOs), holding the whole health budget for a defined local population. The first IHOs are intended to be designated in 2026 and operational in 2027, making seamless data sharing across primary, community, hospital, and social care absolutely essential.

What You Can Do Now in Your Neighbourhood

The 10-Year Plan sets out an ambitious vision that will require significant investment, but neighbourhood leaders don't need to wait until 2028 to improve data sharing.

First, understand where you are now.

The Single Patient Record will be most effective in neighbourhoods that have already done the hard work of collaborative working, relationship-building, and process improvement. So before you start planning, ask yourself:

Do you know where data flow stops in your local system and causes problems?
Can your community providers see the same patient information your GPs see?
Are your third-party providers (pathology, radiology, mental health services) properly integrated, or do they create information gaps?
Do you have mechanisms to hold poor-performing data suppliers accountable?

Understanding your neighbourhood's data maturity isn't just about ticking boxes, it's about identifying where workflow breaks down and patient safety is compromised.

Then take practical steps.

Whilst the national infrastructure is being built, there are four things you can do locally to improve information flow and collaborative working:

1. Map Where Data and Communication Break Down

Work with your teams to identify the specific pain points:

Where does information stop flowing in your system?
Which third-party providers create information gaps?
Where do patients fall through the cracks when moving between services?
What communications regularly fail or arrive too late?
Which administrative burdens are being transferred without consultation?

Document these problems clearly. They're not just frustrations. They're the business case for interim solutions and eventual system investment.

2. Get the Right People Around the Table

Once you know where the problems are, convene regular meetings with everyone involved:

GP practices and PCN leadership
ICB commissioning and digital transformation leads
Community service providers
Mental health teams
Social care representatives
Third-party providers (pathology, radiology, pharmacy)
Secondary care representatives

These aren't just information-sharing meetings. They're forums to solve the specific workflow breakdowns you've identified.

Your ICB colleagues are essential here as they hold the commissioning levers, the relationships with acute trusts, and often the budgets for digital infrastructure.

Without them at the table, you can't address system-level issues or influence contract specifications.

3. Set Up Interim Processes Where Technology Doesn't Exist

Where automated data flow isn't possible yet, create structured manual processes:

Agreed communication protocols when radiology or pathology appointments are cancelled
Clear escalation routes when lab results are questioned or appear incorrect
Notification processes when reference ranges or clinical protocols change
Consultation requirements before secondary care implements changes affecting primary care

These interim solutions may feel like sticking plasters, but they prevent the daily workflow chaos that demoralises teams and risks patient safety.

4. Build Accountability Into Contracts

When commissioning or renewing contracts with third-party providers, work with your ICB colleagues to ensure:

Clear data quality standards and reporting requirements
Contractual penalties for poor performance or repeated errors
Service level agreements for communication and notification
Requirements to use NHS data standards (SNOMED CT coding, for example)
Regular performance reviews with meaningful consequences

Without contractual levers, you have no way to enforce standards when providers repeatedly make mistakes.

This is where your ICB relationship becomes crucial. Many of these contracts sit at the system level, so neighbourhood leaders need to feed intelligence upwards about where providers are failing and what contractual mechanisms would actually make a difference.

To conclude

The NHS 10-Year Plan envisions patients with a 'doctor in their pocket' by 2035, where the Single Patient Record enables truly personalised, coordinated, and proactive healthcare.

If we get this right, neighbourhood health won't just be a model for local care. It will be the foundation for health systems all over the world.

Call me naïve, but I am hopeful. And hope, combined with practical action and perseverance, is how transformation actually happens.

About Us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. We've supported more than 300 PCNs through interim management, training, and consultancy.

Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blogs sharing insights about primary care networks.