The SPR must be built for the health system to come

If you ask most people how they manage their health today, the answer rarely fits neatly inside a single system. They see their NHS GP for some things and may order regular prescriptions through an app. They may pay privately for physiotherapy, mental health support, or weight management, and increasingly turn to apps and wearables to manage their fitness, sleep, and general wellbeing, too. Almost two million people in the UK are now estimated to be accessing GLP-1 treatment through private providers alone.

This increasingly diversified approach to personal health management reflects a structural shift in how healthcare is used, and it is accelerating. Patients increasingly move between NHS and regulated independent services as a matter of routine, choosing the route that gets them safe, timely care. This blended model clearly exists, and is here to stay. The question we would sincerely ask policy makers is, can the infrastructure underneath it keep up?

What the Single Patient Record gets right

This is why the Health Bill matters so much. The creation of a Single Patient Record (SPR) is one of the most significant reforms to health data in a generation, and we should be clear about what it gets right. When patients move between the NHS and regulated independent providers, having their patient information follow them is genuinely a matter of patient safety and not just a convenience. It moreover protects the choices patients have made about how and where they access treatment. A unified record, visible to patients and built on a statutory framework for data sharing, addresses a real and longstanding failure. The ambition to give patients genuine control and visibility over their own data is a meaningful step forward.

This is really a question of data ownership. If the principle behind the SPR is that the record belongs to the patient, then it should follow the patient, with their consent, wherever they receive regulated care. A patient who chooses a regulated digital provider for weight management has not opted out of joined-up healthcare. Their treatment still interacts with their NHS care, their medical history, and their long-term risk profile.

The fragmentation the SPR is designed to fix is largely the fragmentation of the traditional system. These are records scattered between GP practices, hospitals, and social care. While that problem is real and worth solving, it is also, in important respects, old news. If we build the SPR purely to tidy up the past, we will have spent years of effort and significant public money creating a record for a health system that is already changing shape. At this pace, policy will remain just out of reach of the ever changing reality of modern healthcare.

Building for the health system to come

The health system of the 2030s will not look like the one the current architecture was designed around. Care will be more distributed, more digital, and more blended across various providers. The 10-Year Health Plan itself anticipates this, with its ambition for a digital-first NHS and care that happens closer to the patient. A record that follows the patient only as far as the NHS will not reflect how millions of people actually receive care. It will simply create a new kind of fragmentation.

There is also a practical gap that needs resolving now. Regulators expect digital prescribers to verify medical history and risk factors, yet, regulated digital providers cannot access the Summary Care Record or equivalent shared records. Patients can be asked to upload their own NHS information, but simply being able to access existing NHS records, with consent, would be more reliable and moreover easier to audit.

Providers are, in effect, being held to a standard the system does not yet let them meet.

The answer is not unrestricted access. Providers that meet defined information governance, identity verification, and audit requirements ought to have consent-based access. Access should be risk-based and proportionate: an important clinical tool, particularly for higher-risk patient cohorts, rather than a blanket precondition for every prescription. Crucially, this does not require a fundamental redesign of the system's architecture. It is a practical interim step, available now, while the scope of the SPR is still being settled in a fast-moving landscape, and one that could evolve as that architecture develops further. Record access with consent would strengthen oversight in the meantime, giving clinicians the same trusted information relied on across the rest of the system.

Building genuine connection from the start

There is a wider prize here, too. According to Frontier Economics and Nesta, obesity and excess weight cost the UK economy around £126 billion a year, including £31 billion in lost productivity. Regulated digital providers are helping people prevent illness, change behaviour, and manage conditions earlier, reducing pressure on GPs and hospitals and helping people stay in work. Getting the data architecture right is part of what allows that contribution to grow safely, as part of the UK's prevention and health-led growth agenda, rather than at the margins of it.

The Health Bill sets the framework, but the decisions that will determine the SPR's reach are being made now, in the regulations and access standards that follow. Those decisions can either anticipate the new health system we are becoming or codify the old. We have an opportunity to learn, improve, and build something genuinely connected from the start.

The window to get this right is open. It will not stay open for long.

About the author

Rachael Joy is chief clinical and strategy officer at SheMed, a women-focused health tech company tackling long-standing gaps in women's healthcare. A registered nurse and independent non-medical prescriber, she has spent over a decade working in digital health and prevention-led services, having previously held senior clinical roles at Babylon Health and eMed, where she led the design and scale-up of large digital weight management programmes. At SheMed, she oversees clinical, research, and product strategy, including real-world evidence work on the wider impact of GLP-1 therapies on women's health. SheMed is a member of CoRDH, the Coalition for Responsible Digital Health.