NHS ‘modernisation’ bill to include single patient record and ICB commissioning of primary care

The Government will push forward with NHS reforms including introducing the single patient record and abolishing NHS England, with primary care commissioning being transferred to ICBs.

Announced in today’s King’s Speech, the NHS Modernisation Bill will ‘build the single patient record’ and ‘support ICBs to become strategic commissioners’ for primary care.

In his statement in the House of Lords, the King said that ministers ‘will push forward with significant reforms to the National Health Service’.

Briefing documents which followed the speech said: ‘The NHS Modernisation Bill is integral to the Government’s plans to improve care for patients through investment and modernisation.

‘It will enhance patient safety and experience through a new Single Patient Record, enabling joined up, proactive care and empowering patients.

‘The Bill puts power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy.’

The Bill will enable people to see their own health records ‘securely on the NHS App’ and this will apply to those receiving maternity and frailty care by 2028, with ‘learning from this applied to the wider rollout’, the documents added.

It will also abolish NHS England by transferring its functions into the Department of Health and Social Care or the wider system, and support ICBs to ‘become strategic commissioners by transferring responsibilities for all but the most specialised commissioning functions to ICBs’, including primary care, dentistry, ophthalmology and pharmacy.

The King’s speech briefing documents also mentioned ‘information silos across hospitals, GPs and community care’ which ‘force patients to repeat their stories’ and clinicians to ‘work with incomplete data’.

Independent public deliberations showed support for the single patient record was ‘strong and wide’, as it was described as a ‘long overdue fix to fragmented care’ and ’76 per cent were in support of a single patient record’, the documents said.

The briefing documents about the modernisation bill further said it would ‘give ICBs the flexibility in how to manage their local systems by refining the membership of their boards’; and that it would ‘streamline the planning process’ for ICBs, ‘allowing for greater flexibility’.

RCGP president Professor Victoria Tzortziou Brown said: ‘General practice must be at the heart of any reforms to the NHS, with both GPs and patients fully involved in the design of local services and decision-making. We are, therefore, highly concerned by proposals that could reduce the voices of GPs and their patients within local NHS structures. We will want to see the detail of the Bill to ensure these voices are properly represented.

‘GPs and our teams are often patients’ first point of contact with the health service. We play a vital role in coordinating their care and helping them stay well in their communities. We know our patients and understand the health needs of our communities deeply, so the College believes there should be a GP on every ICB to help ensure local decision-making reflects patients’ needs and frontline clinical experience.’

Commenting on the plans for the single patient record, Professor Tzortziou Brown said the RCGP was ‘encouraged by efforts to modernise the NHS and improve the way information is shared across the health service’.

‘Done well, this has the potential to improve patients’ experiences of care and reduce fragmentation between services. But any move towards a Single Patient Record must be carefully considered and evaluated, and include robust safeguards to protect patient confidentiality and ensure public trust.’

Dr Pallavi Bradshaw, medical director at Medical Protection, said: ‘We support the ambition behind a unified patient record across the NHS, and recognise the benefits this could bring in terms of patient safety, continuity of care, more efficient appointments and increasing patient autonomy.

‘However, the administrative burden involved with its rollout and management could be considerable – especially for GPs and practice staff – and this must be mitigated. Robust safeguards would also need to be in place to protect patient data, and ensure the new system does not undermine public confidence in the principle of medical confidentiality. We will monitor the Bill closely as it progresses and more details emerge.’

Earlier this week, the BMA said that GPs had been ‘sidelined’ from the single patient record’s development, adding that the plans were destined to fail.

Plans for the single patient record were first outlined in last year’s 10-year plan, with the Government saying that it would make patients’ data visible to clinicians across different care settings and will also be available for patients to view on the NHS App by 2028.

Last month, Pulse revealed GPs would not be the data controller for data in the single patient record, with controllership expected to be transferred to NHS England.