Public favours tiered system of access for single patient record

The public do not want all health and care professionals to have full access to a single patient record (SPR) and would prefer a tiered system of access, according to government research.

NHS England and the Department of Health and Social Care commissioned agency Thinks Insight & Strategy to conduct a large-scale public engagement programme to build and maintain public trust in how data is used across health and social care.

In October 2024, the government announced plans to launch a SPR as part of the NHS 10 year health plan, summarising patient health information, test results and letters in one place, through the NHS App.

The public engagement programme, which took place in 2024, involved discussions with a core group of around 120 people, another 76 from ‘seldom heard groups’ and an online survey of 2,000 people.

A report summarising findings of the research, published in June 2025, says that in discussions participants “generally agreed that the main advantage of having a single patient record would be efficiency, thus leading to improved care and better health outcomes”.

It adds that “relief was felt at the idea that a single patient record could end the need for patients to repeat their health information multiple times across different health and care settings.”

However, participants rejected the idea that all health and care professionals should have full access to an individual’s SPR.

Instead, they favoured a tiered system of access, based primarily on urgency and breadth of care responsibilities, with access restricted to the relevant elements of a SPR.

An audit trail was seen by the public as a key part of a record system, identifying who had accessed which parts of the record.

The report makes the following policy recommendations on the SPR for the government to consider:

• Proceed at pace – a SPR feels like a long-overdue solution to many of the frustrations the public feel across multiple health and care settings.
• Include a record of access – an audit trail will provide reassurance that access is subject to constraints and oversight.
• Tiered access is essential – constraints on access are essential to the public trusting a SPR. The idea of open access to all health and care professionals is roundly rejected.
• Ensure rigorous training in data use and data security – any health and care professionals accessing a SPR should be trained, so the public are reassured that their data is being used safely and appropriately.
• Patient access is a must – this can help patients better manage their own health, and many felt they had the right to access data about them. While patient access is important, it was a lesser implementation priority compared to access for health and care professionals.
• Focus on and demonstrate high levels of data security
• Be transparent from the start during implementation, as well as in day-to-day operation – acknowledge risks up front and ensure patients have a say in implementation.

Digital Health News exclusively revealed in February 2025 that the SPR will be available to researchers by default, as well as to providers, patients, policymakers and researchers.