NHS England outlines path to Single Patient Record
Image by Erwin Bosman from Pixabay
A recent Global Government Forum webinar brought together NHS leaders, technologists and clinicians to explore what the Single Patient Record will mean in practice and what it will take to deliver it
A Single Patient Record (SPR) that brings together a patient’s health information, visible through the NHS App, is one of the boldest commitments in the 10 Year Health Plan.
The ambition is clear but the question for many NHS organisations has been how this will happen and what exactly it means for them and their patients. While there are still plenty of unknowns, a recent Global Government Forum webinar shed some light on what the SPR will look like as well as pinpointing key issues that will need to be addressed.
Paul Wilkinson, digital delivery director and programme director for Transforming and Connecting Care at NHS England – who is leading delivery of the SPR – told attendees that the SPR is now moving towards the initial stage of delivery, with the first tangible capabilities expected in 2027.
“I think most people would agree that clinicians and patients shouldn’t have to navigate fragmented information,” he said, but acknowledged that views differ on the route to achieving that.
“We’re not looking to reinvent the wheel,” Wilkinson said. “We want to build on what already exists.”
NHS England has been engaging with clinicians, suppliers and patient representatives to shape plans.
A ‘federated record’
While he acknowledged that there is “a lot more to do to understand not just the vision, but how we get there”, he did share some concrete milestones.
Wilkinson said NHS England is working towards delivery in 2027 of a core patient record, initially aimed at providing value to clinicians and designed to expand over time. Smaller pilots will focus on maternity and frailty, including bringing together health and social care information.
The SPR will initially operate as what NHS England calls a “federated system of record”. Information will remain in underlying systems – such as hospital electronic patient records, GP systems and shared care records – and continue to be mastered there.
Over time, NHS England could envisage information being entered directly into the SPR, requiring the development of write-back capabilities, though that is not the initial model.
NHS trusts, integrated care boards and GP surgeries have already invested heavily in EPRs and shared care records. The opportunity, Wilkinson said, is to build on those capabilities while overcoming their geographical boundaries.
“We certainly don’t have a plan or a version of reality where we have one patient record and it’s ubiquitous and it’s all being provided from the centre,” he said.
Asked how the SPR relates to the Federated Data Platform, Wilkinson said they are different capabilities: the FDP provides analytics and helps trusts manage operational performance, using information such as shift rotas and theatre utilisation, while the SPR is a system of record for structured patient data.
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Building on shared care records
The approach makes the experience of more mature shared care records important to the development of the SPR.
Dr Dan Alton, chief clinical information officer for NHS Thames Valley and clinical lead for the Thames Valley and Surrey Shared Care Record, said the system is now relied upon by clinicians and professionals day-to-day.
“It has required quite a journey to get to where we are,” he said.
“I don’t want anything to disrupt that. I don’t want any reduction in the functionality I have at the moment.”
And for busy clinicians, whatever the SPR looks like, it needs to be “seamless and better than we have at the moment”, he said.
Thames Valley has made electronic ReSPECT forms – which record patients’ wishes about their future treatment – available through its shared care record. Previously, these documents would be kept physically in patients’ fridges so paramedics could locate them in an emergency.
Alton also highlighted how the benefits of bringing data together can extend beyond traditional healthcare. In Thames Valley, linked data has been used to identify people who may be particularly vulnerable in a fire – for example because they have mobility problems or use home oxygen. With patients’ permission, they can be referred to the local fire and rescue service for preventative support.
Alton said this was “very, very different from where our shared care records started”, when the primary goal was to give clinicians visibility of linked information.
“In terms of the Single Patient Record, there are benefits certainly when it comes to delivering these kinds of innovations,” he said.
Data standards
Lee Rickles, chief information officer at Humber Teaching NHS Foundation Trust and director of the Yorkshire and Humber Care Record, said the region deliberately pursued a standards-based, real-time and user-centred approach.
Rather than creating a monolithic system, it developed a modular architecture using open-source solutions, federating information from systems including GP practices, acute providers and local authorities. The solution is jointly owned by the NHS organisations and local authorities in the partnership, rather than by a vendor.
When suppliers did not support the required standards, the team built adapters. And when it encountered what Rickles described as a “massive absence of standards around social care data”, it worked with providers and standards organisation HL7 to develop new ones.
“Standards are absolutely essential for getting consistency of data, especially when you’re flowing between different systems,” he said.
Wilkinson said that NHS England is developing a “canonical data model” – a common language allowing information held differently by GP systems, acute trusts, mental health providers, community services and others to be represented consistently.
A big focus now is working with providers, ICBs, clinicians, and others to define data standards, as well as engaging the supplier market and also providers who have contracts with them, he said.
NHS England has begun engagement with the technology market, including workshops involving more than 40 providers, as it develops requirements around interoperability.
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Beyond technology
The technical challenge, however, is only part of the problem.
Existing shared care records have also required years of work to establish governance arrangements and persuade organisations and professionals to feel confident to share their data.
This is particularly significant in general practice, where Alton described GP records as perhaps the richest source of patient information in the NHS.
Of the 193 GP practices in the Thames Valley geography, 191 have agreed to share their data into the regional record. Reaching that point involved extensive engagement, including visiting practices and sometimes bringing patient representatives along to discuss concerns and build trust.
“I am concerned that if we have to start afresh somehow, this will be a big, big challenge,” Alton said. “It has taken a vast amount of time to build that level of trust.”
Patient trust presents a related challenge as access to information widens. Alton said role-based access controls would be essential: a social care professional, for example, should not necessarily see the same information as a GP. Strong auditing would also be required to identify inappropriate access.
“We need to have a very robust auditing system so we can assure everyone that if there is inappropriate access, that will be audited and hopefully discovered,” he said, adding that effective patient and public engagement, as well as engagement with professionals, would be critical.
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Next steps
As the SPR programme moves ahead, speakers said that previous national technology programmes provide important learnings.
“We can’t buy one monolithical system and replace everything else with it. It absolutely fails,” Rickles said.
Alton similarly argued that the technical, clinical, patient and information governance worlds all need to be aligned.
“It can’t be led from a technical central perspective,” he said.
Wilkinson was clear that NHS England wants to build on existing value and not operate from an “ivory tower”.
He said he was “really confident we’ll be delivering something tangible next year”.
But that will not mean the Single Patient Record is finished. “That won’t be the end point. That will be the start point,” he said. “So, when will it be finished? I don’t know. It might never be finished.”
He urged NHS organisations to continue “challenging us, giving us input, working with us as we start to try and shape up where we can deliver value”.
The webinar was moderated by Andrew Besford, non-executive director and chair of the digital committee at Gateshead Health NHS Foundation Trust. Besford also authored GGF’s report titled A Fresh Mandate for Digital Leadership in the NHS, which was published in October 2025 and based on interviews with digital leaders in NHS trusts in England.
Reflecting on the discussion, Besford said: “The pace from the centre is clearly picking up, and the willingness to engage is welcome. Around 300 people joined us, and we had so many questions we could not get through all of them. This shows there is a great deal of interest and, underneath it, real concern and confusion about how the Single Patient Record will fit with what already exists.
“The panel’s answer to that question was clear enough: their own description of the SPR is less a new record than creating the connections between the records we already have, plus a window for patients. A clear statement of direction from the centre along those lines would settle a good deal of the confusion. It is the right answer, and a difficult one, because it means the centre using levers it has struggled with in the past: setting standards and holding suppliers to them, and being clear about what the programme asks of regions that have spent a decade on their shared care record, as well as the support for those which have not. The legislation can make sharing lawful. It cannot make it trusted, and the years Thames Valley spent winning the agreement of almost every GP practice in its area show both how that trust is built and how easily it could be put at risk.
“The invitation to keep challenging and shaping the programme is a good one. We should take it up.”
Upcoming event: Making Digital Deliver for the NHS | 21 October 2026 | Newcastle, United Kingdom
Bringing together national leaders, NHS organisations, clinicians and innovators, the agenda will showcase best practice, share lessons from across the system and focus on turning digital ambition into lasting change.
