One of last week’s most impactful HPN North sessions, chaired by Lee Rickles, brought together experts from Health Innovation Manchester, Prof Jacqui Cooper, Cara Afzal, and Dr Saif Ahmed, to explore what it will realistically take to move from today’s patchwork of regional Shared Care Records (ShCRs) to the long anticipated Single Patient Record (SPR).

The conversation was grounded in lived experience across clinical and transformation leadership. Below is a summary of the key themes, challenges, frustrations, and opportunities discussed.

Why Shared Care Records Have Become Indispensable

Dr Saif Ahmed opened by emphasising how transformative the Greater Manchester’s Shared Care Record (GMCR) has been for frontline clinicians. As a GP, the ability to see recent A&E attendances, test results from other trusts, or specialist input without having to chase colleagues has been a “game changer” for both clinical quality and time savings.

For patients, it reduces the burden of repeatedly retelling their story, a particularly meaningful improvement for people with complex, long term conditions.

Yet Saif noted the gap between what clinicians need and the NHS’s broader digital maturity. While industry can deliver advanced capabilities, NHS adoption, especially of advanced tools like AI, lags significantly.

The NHS App: Gateway or Gatekeeper?

The panel recognised the NHS App as an important future component of the SPR vision, but not one that works for everyone today.

Saif described the realities in Greater Manchester, where many patients, especially older adults with multiple long term conditions, struggle with app onboarding processes that require passports or driving licences. A pilot in Tameside involving heart failure monitoring through the NHS App saw only 5 out of 50 patients able to successfully use it.

Accessibility in terms of languages, readability, and digital literacy was highlighted as a major barrier and a risk. If not addressed, the NHS App could exacerbate inequalities rather than reduce them.

Neighbourhood Models: The New Front Line

Cara Afzal situates the SPR conversation within a wider shift, with neighbourhoods becoming the real “front line” of health and care delivery.

Her earlier work on mental health liaison in A&E demonstrated how giving frontline staff access to the right information at the right time sharply reduced unnecessary emergency attendances. The same principle now needs to be applied to neighbourhood teams across physical, mental, and social care.

Cara stressed the need to design information flows around new multidisciplinary neighbourhood teams, not just traditional clinical settings.

Culture, Confidence and Willingness to Share

Prof Jacqui Cooper tackled what many perceive as the elephant in the room:

“We as clinicians are often the barrier. We do not share our data, and sometimes we do not want to.”

She pointed to long standing cultural norms, along with legal frameworks around GP data ownership, that create friction even when sharing would improve care.

Her example from child safeguarding reviews was stark. Across agencies, each held pieces of information that, if viewed together, would have signalled risk far earlier. The SPR vision is not simply technical, it demands a cultural shift towards genuine, routine data sharing across health, social care, and the voluntary sector.

l-r: Lee Rickles, Prof Jacqui Cooper, Cara Afzal and Dr Saif Ahmed

Interoperability: An Unfinished Story

Jacqui and Cara both highlighted how interoperability remains a fundamental blocker, despite progress within individual Shared Care Records.

Northern regions, including GMCR, GNCR, and Lancashire and Yorkshire systems, should be interoperable because patients routinely cross these boundaries. But in reality, frontline staff are still confronted with PDF exports, multiple log ins, or no visibility at all, as one audience member noted when describing cross boundary urgent care.

FHIR standards exist but have not yet been implemented widely enough to deliver structured, actionable data at the point of care.

Stop Waiting for Permission

A shared frustration across the panel was the NHS’s historic tendency to “wait for permission”.

Saif argued strongly that progress often comes when local systems push ahead rather than wait for national policy alignment. Manchester’s Prevention Demonstrator was cited as an example of bold local leadership driving change by convening the right voices and simply doing what is needed.

Jacqui referenced the Great North Care Record as a success story built through local determination rather than waiting for top-down direction. The future SPR, she argued, will require more of this empowered, pragmatic approach.

Looking Beyond the UK: Learning from Places Already Doing It

Jacqui brought an important international perspective. Other regions, including Catalonia, Estonia, and the Nordics, are already delivering something close to a single patient record using open standards and strong data ownership models.

Her message was clear:

“We need to stop looking inward. Others are doing this today, how did they do it, and what must we learn?”

A Realistic Roadmap

Cara offered a pragmatic view of what the next few years will look like.

Business cases for national SPR ambitions currently do not stack up economically, meaning regions will continue working with their existing assets, GMCR, GNCR, OneLondon, while slowly increasing standardisation and consolidation.

This means:

• making better use of existing capabilities
• reducing the proliferation of vendor systems
• improving consistency across regions
• avoiding the “just buy another system” mindset

Progress is coming, with more clarity expected nationally soon, but the move to an SPR will be evolutionary rather than revolutionary.

So Are We Ready for a Single Patient Record?

Across the panel, there was agreement that the vision is right, but the route is complex.

Challenges include:

• cultural reluctance to share data
• entrenched legal frameworks, such as GP data ownership
• vendor business models that do not incentivise openness
• lack of interoperability maturity
• digital exclusion among patients
• shortages in digital transformation skills
• major gaps in national alignment

And yet, optimism was clear.

Local teams are already solving problems in pragmatic, creative ways. Global exemplars demonstrate that it can be done. Shared Care Records, imperfect as they are, are delivering real value today.

Perhaps most importantly, the panel’s message to the system was this:

Do not wait. Build the future through what works today, and bring others with you.

The SPR is not a single system. It is a journey of alignment, culture change, and sustained improvement. Greater Manchester, and the wider North, is already showing how to get there.