Getting you the right medical treatment more quickly – particularly if your life is at risk: that’s the aim of an NHS reform to unify patient records, so that doctors, nurses and paramedics can see a patient’s complete medical history, no matter where they are treated.
Single Patient Records could mean 20,000 fewer A&E visits and 6,000 fewer hospital admissions annually, said Health Secretary James Murray. This would save doctors about 500,000 hours, and the NHS £20 million, every year.
But plans for SPR, which come before Parliament today, face strong opposition from those who are concerned about the security of patient data and who will have access to it. We need to make sure that this pooled data cannot “be used inappropriately”, said the British Medical Association’s GP committee. “Ambitions to address fragmentation, improve productivity and reduce bureaucracy are laudable but they cannot come at the price of undermining confidentiality and public trust.”
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“The ambition is good,” said Alex Lawrence, a data specialist at The Health Foundation think tank. With its “Lego bricks” approach of stacking information together, SPR is the “most legislatively ambitious attempt” to “make care faster and safer” by getting patient data to “flow more freely” through the NHS system.
But “federating” the data and rolling out the system “is easier said than done”. It is still “unclear” what SPR will look like in practice, and “questions about how access, oversight and public choice will be managed remain unanswered”. Current data-sharing and confidentiality arrangements will be changed but key details – such as an individual’s right to restrict access to their records – have “been deferred to secondary legislation”. Its “absence on the face of the bill is a significant omission”.
“NHS digitisation projects have a chequered history,” said Laura Donnelly, health editor of The Telegraph. “A £12 billion programme for an NHS IT system in 2002 was abandoned” after 10 years, “due to spiralling costs and delays”. And Care.data, which was supposed to “extract GP records into a central database”, had to be scrapped in 2016 “following a public backlash over privacy concerns”.
Previous attempts to bring patient records together have been “beset by technical complexity, a mind-bending web of rules and roles, and some cultural intransigence”, said The Register. This time, the idea seems to be to use the current record systems in conjunction with the “controversial” Federated Data Platform run by US firm Palantir. “Either there’s going to be a new data store, which will be in Palantir, or there will be an infrastructure for bringing various independent APIs together” that uses Palantir’s FDP, Sam Smith, from data-safety campaign group medConfidential, told the news site.
There’s a reason why campaigners like medConfidential are calling SPR the “Single Palantir Record”, said investigative journalist Andrew Orlowski on Spiked. The company’s current contract with the NHS – which centres on using its FDP to improve efficiency – will be “worth over £1 billion if it runs its full course”. Palantir has had success in “winnowing” NHS waiting lists, but applying the singular goal of efficiency to patient data is “inimical to both interpersonal relationships – between patient and doctor – and trust”.
What next?
The plan is for SPR to be rolled out and made available on the NHS app as early as 2027. The Health Secretary has said that the Palantir contract was being reviewed ahead of its break point next year.
The NHS Modernisation Bill, which includes plans for SPR, as well as the abolition of NHS England, will have its second reading in the House of Commons today. Former Health Secretary Wes Streeting will speak from the backbenches to “back the bill he drafted”, said Donnelly in The Telegraph. He will no doubt “hail the changes” he made as health secretary and take “credit for the introduction of new AI tools and a funding uplift for GPs”. It’s a clear opportunity to boost his Labour leadership campaign.
