The Single Patient Record: Keep an eye on the prize

The new chief executive of The NHS Alliance says the government’s proposed Single Patient Record (SPR) for the NHS offers the prospect of swifter, safer, more effective care, but a major task lies ahead in winning the trust of staff and patients to ensure its success.

Speaking ahead of the biggest health conference of the year, NHS ConfedExpo, Sir Ciarán Devane said that while the programme had huge potential benefit it was vital to learn from previous national data sharing programmes which, despite huge investment, have often failed to deliver on expectations.

The SPR is a key component of the government’s Health Bill currently going through Parliament and it sits at the heart of its 10 Year Health Plan for England. The aim is to summarise patient health information, test results and letters in one place electronically – all accessible through the NHS App. This would allow patients to see their entire digital health record and enable clinicians to act promptly on the right information at the right time.

Providing this "single point of truth" should help ensure higher quality, safer, more joined up care across the NHS. It should allow a greater focus on preventive interventions to keep people well and improve the planning of services to meet the needs of individuals and communities.

However, as the legislation takes shape, it is clear there are concerns over privacy, security and safety of data. The government has offered some initial reassurances. However The NHS Alliance, which speaks for leaders across the health and care system, says the importance of winning the trust of NHS staff and the public cannot be over-stated, and it has urged politicians to keep sight of the gains at stake for patients as they seek to address the risks.

Sir Ciarán Devane, chief executive of the The NHS Alliance, who has extensive experience of national data programmes, said:

"Our members wholeheartedly support the ambitions of the Single Patient Record. It is essential to realising the aspirations of the 10-Year Health Plan, transforming care for patients, so it’s quicker, safer, seamless and closer to home.

"It can also help NHS leaders develop more effective, productive and better coordinated services, allowing them to focus more on prevention and supporting a healthy population.

"But of course there are potential risks and it’s encouraging to see the government is thinking about security and safeguards.

"The NHS Alliance has its own concerns, particularly over who controls and is formally responsible for the data. At present this “data controllership” sits with GPs so they hold liability for data accuracy and safety. An SPR creates new risk for GPs for data sharing beyond their direct control, while shifting aspects of data controllership to the Secretary of State or national bodies risks a disconnect between those exercising control over the system and GPs carrying legal responsibility.

"The Health Bill must provide clarity on data controllership and liability for each function of the SPR. Operating under national standards, local NHS systems should retain clear responsibility for implementation and use in direct care where accountability is clearest.

"We have arrived at a key moment in this debate which may determine whether the Single Patient Record stands, or like so many of its predecessors, falls. The issues are complex and often technical, but ultimately it comes down to one word: trust.

"We need the public to feel confident that the system is in safe hands, that their data will be secure, with clear and effective safeguards on how it is used. But above and beyond that we need to win the trust and support of NHS staff so they feel comfortable and confident in using it and so that they can see how it will improve and simplify their IT interactions rather than serving up a new layer of complications, duplicated effort and time wasted. They need to see how it will improve the care of individual patients and of the local population.

"There is a key message here for everyone who engages in this important debate: to keep your eye on the prize. Yes, there are very important and legitimate concerns over how this programme is implemented. And yes, we need strict safeguards to protect the way this data is controlled and managed.

"But I appeal to everyone involved in shaping and influencing this legislation, including our politicians, to bring a constructive mindset, free of dogma and prejudice, to make the Single Patient Record the best it can be. We must learn from past mistakes by building understanding from the word go, so people recognise the opportunities offered by this programme. The potential benefits are too great, and the price of failure is too high, to do otherwise."