Patients Call for Greater Transparency in NHS Single Record Plan
Patients involved in shaping the NHS’s single patient record initiative have called for clear audit trails to track who accesses their health data, highlighting transparency and accountability as top priorities in the digital transformation of care.
The views are detailed in a new report by NHS England’s Transformation Directorate, following nationwide public engagement prompted by the October 2024 announcement to develop a single, unified health and care record across the NHS in England.
The engagement included discussions with over 100 participants, input from 76 individuals from underrepresented communities, and responses from a broader survey of 2,000 people.
The report found widespread support for the idea, with participants citing the potential for better-coordinated care and greater efficiency. However, concerns were raised around data accuracy, privacy, and potential misuse. On balance, most agreed that the potential benefits outweighed the risks.
Key themes that emerged include the need for:
- Robust accountability in data use
- Patient control over data sharing
- Strong security safeguards
- Full transparency in how records are designed and accessed
In response, policy proposals now recommend that each patient record include a detailed audit trail, logging who accessed which elements and when. Participants also endorsed tiered access controls to ensure that only relevant healthcare professionals can view specific types of information.
“An audit trail was seen as an essential component of the system,” the report notes, with seldom heard groups in particular stressing its importance as a safeguard against misuse.
Other recommendations include mandatory staff training in data handling and security, and improved patient access to their own information.
The report also highlights a call for more consistent, transparent governance of how general practice records are used for secondary purposes, such as service improvement.
Respondents favoured moving away from over-reliance on individual GPs and adopting a more standardised, collaborative approach, balancing national oversight with local flexibility and including input from GPs, the public, and data security experts.
