The government’s proposed Single Patient Record (SPR) for the NHS could transform care by making it faster, safer and more joined up – but only if it earns the confidence of NHS staff and the public, according to the new chief executive of The NHS Alliance.
Sir Ciarán Devane said the SPR offers a “huge potential benefit” for patients and clinicians alike. However, he warned that lessons must be learned from previous national data initiatives which absorbed significant investment yet failed to deliver the anticipated gains.
The SPR forms a central pillar of the government’s Health Bill, currently progressing through Parliament, and sits at the heart of its 10‑Year Health Plan for England. The proposal would bring together patient health information, test results and clinical correspondence into a single digital record, accessible through the NHS App.
The ambition is that patients will be able to view their complete digital health record in one place, while clinicians will have immediate access to accurate, up‑to‑date information – enabling better decisions at the point of care.
Supporters argue that this “single point of truth” could significantly improve patient safety and quality, reduce duplication, and support more integrated care across organisational boundaries. It could also strengthen prevention, population health management and long‑term service planning.
Yet as the legislation takes shape, concerns remain around data privacy, security and accountability. While the government has offered initial reassurances, The NHS Alliance says the success or failure of the SPR will ultimately depend on trust.
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."
The NHS Alliance says clarity on governance, liability and local accountability will be critical if the SPR is to avoid the fate of earlier national IT programmes. As debate around the Health Bill intensifies, Sir Ciarán’s message is clear: without trust, even the most ambitious digital reforms will struggle to succeed.
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