Single patient record to include primary, secondary and social care data, DHSC confirms

The NHS single patient record will ‘contain medical history from birth’ and will initially cover data from primary and secondary care, expanding over time to include services such as adult social care, the Government has confirmed.

In an impact assessment, the Department of Health and Social Care said that ‘specific legislative powers’ were needed to create the single patient record because of previous public controversies surrounding two other GP patient databases. 

As announced in the King’s speech earlier this week, the Government is pushing forward with NHS reforms including introducing the single patient record as part of the health bill, which was introduced in the House of Commons yesterday.

The single patient record data will include diagnoses, physiological data (such as blood pressure, heart rate), medical imaging, prescriptions and medications, key primary and secondary care NHS interactions and more (see box).

The document said that legislation would ‘create an offence or other civil sanctions to enforce the regulations’.

It said that the requirement to input data into the single patient record, which ‘will be
set out in regulations’, is ‘expected to apply’ to people involved in the provision to patients of
health services or adult social care in England, including GP practices.

‘These provisions will enable Secretary of State to require or authorise health and social care
providers and their IT suppliers to process data for SPR purposes, and in turn to update
other clinical systems to reflect changes to the SPR,’ the document said.

It comes after Pulse revealed that GPs would not be the data controller in the single patient record, with controllership expected to be transferred to NHS England. However, the document did not specify who the data controller will be.

On the possibility of controversy around the single patient record, the documents said: ‘Drawing on the recent experiences of care.data, and GP Data for Planning and Research, the use of public data in a centralised way is likely to be high profile and attract some controversy.  

‘It is therefore both necessary and prudent to create specific legislative powers to establish the SPR. Clear statutory provisions would support public confidence, ensure appropriate parliamentary scrutiny and provide the flexibility needed to adapt to future developments in data use and technology.’ 

The Government has not decided yet on the technical solution which will be used for the single patient record, but it said that this will be ‘designed to integrate with existing architecture with minimal additional resource needed’ and will not make additional demands on providers to ‘digitise’.

The impact assessment document estimated the total cost to providers of introducing the legislation to be around £32.8m in 2026/27 though could be as high as £55.1m.  

For the nearly 6,000 NHS GP practices in England, this includes £2.7m in ‘familiarisation costs’ – the cost of staff time to understand the new data obligations – and £2.3m in administration costs. 

The document said: ‘The total direct cost of the introduction of legislation is estimated to be £32.8 million, with a range of £10.2 million to £55.1 million. This includes familiarisation costs, administration costs and onboarding costs, which all occur in year one only.

‘As with any new legislation, staff time will be required for organisations to understand the new obligations and how they apply.

‘These costs apply directly to all health and care providers and IT suppliers. This cost is transitionary, occurring in year 1 only.

‘DHSC expect familiarisation requirements to be relatively limited. Data sharing processes already exist between NHS England, health and care providers and their IT suppliers, and the burden of data collections on providers are often assessed by NHS England as being minimal.’

It also said that the total direct and indirect benefits of the legislation are estimated to be £109.6m over 10 years.

The document said that the familiarisation and administration costs ‘apply directly to health and care providers’. Pulse has asked DHSC if these will be reimbursed by the department.

The King’s Fund chief executive Sarah Woolnough said: ‘The Single Patient Record represents the greatest opportunity to improve people’s experience of the NHS and their health contained within this legislation.

‘On the NHS App, people would be able to see their primary, secondary and social care record all in one place, ending decades of frustrations around fragmented information and care.

‘There are concerns over who will ultimately be responsible for the data and ministers must ensure it is designed carefully to allay those fears. It is likely to be the most controversial element of the NHS Modernisation Bill but is worth making the argument for and one that we hope the government wins.’

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. 

GP-record sharing scheme care.data was suspended in 2016 after more than a million patients opted out amid concerns about how their data would be used and shared with third parties. 

And last year, Pulse revealed that then health secretary Wes Streeting was planning to issue a legal Direction to reverse the ‘pandemic only’ requirement covering the GP Data for Pandemic Planning and Research (GDPPR) dataset. 

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.