The DHSC has conducted an impact assessment designed to support proposed legislation for the Single Patient Record (SPR) contained in the recent Health Bill, and assess impact across nine protected characteristics including disability, sex, race, and sexual orientation.
The department reiterates current policy aims for the SPR around giving patients control of their data and medical history, offering a “single version of the truth” accessible across different care settings, and forming the foundations for patient information to flow safely and seamlessly between care providers. The record is designed to “significantly reduce” the admin burden on clinicians, it states, supporting better-informed decision-making and more coordinated care, including, in the future, adult social care. For patients and service users, it is intended to improve experience and care, with access to be offered through the NHS App by 2028 to full medical history, test results, appointment and test booking, medicines and vaccinations management, and support for long-term conditions.
DHSC shares insight from national public engagement on the SPR, which received approximately 2,200 responses, including from individuals with specific health needs, or those from socially marginalised communities. This work found support for the SPR, it notes, with more than three-quarters being in favour. Findings from engagement with 76 people from seldom-heard groups such as older people with long-term conditions, people from ethnic minorities, and those with a disability, found similar results, and identified that those who frequently interacted with health services felt it could help improve the continuity of their care.
On impacts, the DHSC looks first to disability. “Currently, fragmented systems mean that vital information such as diagnoses, lab results, treatments, prescriptions and care plans do not always follow the person,” it highlights. “This can lead to repeated history taking, duplicate tests, delays in discharge and increased risk of patient safety incidents.” SPR legislation is aimed at improving information sharing across those involved in a person’s care, it continues, and is therefore expected to have an “indirectly positive impact” on all people, with those interacting with care in a range of settings assumed to “disproportionately experience the benefits”. However, those who interact more with services are likely to have more information held on records and could feel the impact of cyber breaches more, the DHSC states, and whilst those who are digitally excluded will still benefit from healthcare professionals having access to more information, “they are less likely to immediately experience the benefits of personal access to the SPR through the NHS App”. The App’s proxy access will help counter this, it adds.
The DHSC goes on to note that women are generally more likely to use healthcare services, and more likely to report one or more longstanding health conditions. This means the same issues can arise from fragmented systems that mean information does not follow them around the health system, leading to delays, duplication, and increased risk, it states. It reports on the same issues with increased use of healthcare services and raised risk from cyber breaches, but notes access to health data may make it easier for patients to take steps to understand and improve their health.
Further, it looks to domestic violence, citing statistics showing women account for 72.5 percent of victims. “People who experience domestic violence could face challenges in accessing their SPR through the NHS App, especially if they are being coerced or controlled – for example, if the abuser has control over their phone,” it adds. Guidance on safeguarding for the NHS App has been published, it continues, that allows restrictions to be placed on access to clinical records through the App, which could in turn mean those experiencing domestic violence are less likely to benefit from personal access to their record.
Moving on to health inequalities affecting boys and men in England, the DHSC makes note of statistics showing suicide is the leading cause of death among men under 50 in the UK, that men are less likely to seek help for mental health issues, and that men are “more likely to engage in risky health behaviours such as smoking, excessive alcohol use, and poor diet”. They also tend to make fewer GP appointments, it adds, meaning the ability to view their SPR through the NHS App may encourage engagement with their health and care.
Similarly, for ethnicity, the DHSC cites evidence that people from some ethnic minority groups might be more likely to report being in “poorer health”, and at increased risk for patient safety incidents. “There is indicative evidence suggesting that minoritised ethnic groups have a higher risk of developing multiple long-term conditions and do so earlier than the White majority population, which typically require health and care services across a range of health and care settings,” it states, creating challenges in information not following them across the system, and increased likelihood of impact from cyber breaches. It also points to increased likelihood of suffering from digital exclusion, including language barriers making it difficult to understand information or navigate the health system, and fear of data on immigration status being recorded that can lead to “disengagement from health services”.
Considerations for impact are also made across additional protected characteristics including age, gender reassignment, religion or belief, pregnancy and maternity, marriage and civil partnership, and other identified groups.
Further partnerships and collaborations are planned to reach members of the public needing additional support in using the NHS website and the NHS App, according to the DHSC, and mitigating the risk of digital exclusion is one of five main priorities NHSE has asked ICBs to address in their work on health inequalities. Further mitigations will also be made alongside SPR development, it outlines, with ongoing monitoring looking at specific impact on equalities. Effectiveness of SPR legislation will depend on a series of external factors, such as provider and supplier capacity to comply, interoperability and data quality, patient trust, and delivery of the wider NHS digital agenda, it adds.
In an impact statement published earlier this year, the DHSC noted the single patient record will take several years, and costs will include product development, tech and data integration, delivery, implementation, and commercial costs. Investment will be needed to ensure staff such as paramedics and community pharmacists have the same access to patient data as GPs and those working in hospitals, and to maximise value, costs may also need to be considered for translating care records into plain English to be understood by patients. Costs of personalised social risk assessments, the development of data collection to the NHS App, and tools to integrate information with other datasets, are also explored. Benefits anticipated include reduced variability through automated triage of patients, enabling more informed decision making, and reducing more expensive downstream health costs. Risks cover reliance on a single provider and “de-facto vendor-lock”, as well as clinical resistance to changes in data sharing.
Wider trend: Health data
The newly-created Central East ICB, formed from Bedfordshire, Luton and Milton Keynes ICB, Cambridgeshire and Peterborough ICB, and Hertfordshire, has revealed its five-year approach from strategy to delivery, highlighting the role of digital and data in achieving objectives and improving outcomes for the local population. Committing to adopting modern, digital mechanisms such as the NHS App by default, and to supporting its population in safely managing their own health with digital access and remote monitoring, the ICB sets out ‘five layers’: prevention and screening, supported self-care, proactive outreach and risk mitigation, care coordination for complex needs, and crisis response and recovery.
Interweave has announced a number of selected suppliers for procurements across infrastructure, portal, care planning, data aggregation, and messaging. The procurements are reportedly hoped to help toward Interweave’s ambition of providing a “vendor agnostic” technology platform, with preferred bidders selected for four different lots covering specialised areas of the platform. The selected suppliers have “expressed a willingness to work together”, Interweave reports.
The Australian Federal Budget for 2026 has been published, with headline commitments to advance interoperability, promote data sharing, and improve access to healthcare services. Among the measures to be outlined in the budget are plans to enhance the My Health Record with an injection of $598.3 million over two years, to ensure both patients and healthcare professionals are able to access reliable and “timely” health data.
