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New report: the digital advantage

While the NHS faced and overcame the greatest challenge in its 73-year history during the Covid-19 pandemic, much preparatory work remains to be done towards the long-term goal of achieving widespread interoperability across the sector.

The road to establishing a national electronic health information system has been long and winding and there are numerous obstacles yet to overcome.

A new, more gradualist approach to addressing these challenges has gained traction over the last five years.

Five Local Health and Care Record Exemplars (LHCRE) are piloting integrated patient health records.

Together, they cover 41.9% of England’s population. The National Data Guardian’s advice has been given legal weight. The Professional Record Standards Body has developed specialised content standards for patient records in 22 different clinical settings.

New training programmes for health informatics professionals have been launched. NHS Digital has published a draft NHS Digital, Data and Technology Standards Framework, which proposes mandatory data standards for interoperability.

So how do we engage with stakeholders to accelerate progress? Here are some measures for immediate implementation that would make a significant impact within the next five years.


  • Conduct a review of the use of blockchain, encryption and coding techniques for security and confidentiality in the Estonian National Health System and other global early adopters.
  • Set up a forum for health informaticians and innovators working on the roll-out of integrated patient records to share technical solutions relating to confidentiality and consent.

Data standards

  • Set an end date for the consultation on the draft NHS Digital, Data and Technology Standards Framework and publicise the exercise more widely.
  • Clarify which aspects of the framework are already mandatory and publish the planned procedures and target dates for giving them legal status.


  • Conduct a post-Covid-19 review on integrated patient records in LHCRE to check progress and set realistic new targets that consider the pandemic.
  • Carry out a cost-benefit review of the various approaches to integrating patient care among LHCRE to identify flexible and effective models.


  • Mount a series of workshops for human resource leaders in NHS trusts using projections of future demand for clinical informatics staff from workforce planning exercises.
  • Conduct information campaigns across universities on upcoming career and training opportunities for clinical informaticians.


  • Hold workshops for tech firms on how to meet the requirements of the Data Security and Protection Toolkit, Digital Technology Assessment Criteria, and NHS Standard Contract.
  • Commission surveys of NHS staff who are using integrated patient health records to identify any issues they may face, so appropriate support measures can be devised.

Read our full report to learn about barriers to interoperability, a frame for digital transition, case studies, our recommendations and next steps, and more.