Making the single patient record work: lessons from Somerset

I support the single patient record. Patients should be able to see their own health information and expect the professionals caring for them to have the information they need. That is an ambition worth getting behind.

For someone living with frailty, the practical test is straightforward: when their condition changes, can the clinician in front of them find the current medication, understand the agreed plan and act on what matters to that person?

Somerset's experience with its shared care record, SIDeR+, offers useful lessons for making that possible nationally. The technology, clinical workflows and relationships developed locally give us something concrete to build on.

A national ambition with practical foundations

The government's single patient record fact sheet sets out a phased ambition for England:

• By March 2027: improved access to records for at least 80% of patients through connected shared care records.
• From 2028: the ambition for all patients to see a core set of their data through the NHS App.
• Initial pathways: maternity and frailty, followed by further pathways including cancer and mental health.
• By 2030: the goal of access to the full range of data for the whole population of England.

The stated approach is to build on and connect existing electronic patient records and shared care records wherever possible. That recognises the investment and experience already present across the NHS.

Connecting those records is an important step. Making the information useful during a consultation, a home visit or an emergency is the test that should guide delivery.

National reach also brings an opportunity to give patients a more consistent experience wherever they receive care, and a clearer view of the information used to make decisions with them.

What Somerset can contribute

SIDeR+ first went live as an electronic palliative care coordination system in 2019 and expanded into a shared care record in 2020. Somerset's April 2026 usage report recorded 5,281 unique users and 96,213 logons during that month. These are measures of use; assessing the effect on care also requires clinical evaluation.

Somerset's clinicians, programme teams and commissioners deserve the credit for that adoption. Working alongside them as their technology partner has taught us four lessons relevant to the national programme.

1. Make live information usable

A clinician needs to know what information is relevant, where it came from and how current it is. SIDeR+ brings together structured data from systems including EMIS and SystmOne GP and Community. Live access and structured information help us present the detail a professional needs for the decision at hand.

2. Let clinicians maintain shared plans

Care plans need to evolve with the person. In Somerset, when a clinician creates or updates an electronic Somerset Treatment Escalation Plan (eSTEP), a copy is automatically sent back to the GP record in real time. The Somerset programme's case study describes how this reduces repeat documentation.

eSTEP launched on 19 May 2025 and passed 25,000 completed plans by May 2026. That is a substantial adoption milestone, supported by the programme's clinical leadership, training and ongoing improvement work (first-year review).

The Parliamentary and Health Service Ombudsman's September 2026 report, Conversations that matter most, recommends prioritising end of life care in the single patient record rollout. It calls for care plans and treatment decisions to be accessible across settings, supported by investment in training. That is a strong case for putting shared planning near the centre of delivery.

3. Invest in adoption and governance

Somerset's programme shows the sustained work required to make a shared record part of everyday care:

• eForm roadshows across all 61 Somerset GP practices, with additional sessions in Devon and Dorset.
• Repeated data reviews to identify variation and guide improvement.
• An eSTEP Governance Group established in April 2026, with its first meeting in May.

This work needs a place in delivery plans and budgets. Training, clinical ownership and the ability to respond to feedback are essential to making a service useful over time.

4. Make cross-border care routine

The Dorset integration announced in December 2024 enabled Yeovil Hospital clinicians to access Dorset GP records through SIDeR+ and create and share care plans with Dorset practices. At the time, around 30% of Yeovil's patients came from Dorset. It is a practical example of why care records need to work across organisational and geographical boundaries.

What I would prioritise nationally

For the March 2027 milestone and the work that follows, I would put five things at the centre of delivery:

• Measure clinical use and patient experience. Track whether information supports decisions, reduces repeated work and helps people understand their care.
• Support shared plans and safe write-back. Make responsibility for creating, updating and reviewing plans clear across services.
• Fund adoption and clinical governance. Give teams time for training, local leadership, data review and continuous improvement.
• Make interoperability dependable. Use open standards such as HL7 FHIR and assured interfaces, with clear expectations for data quality, availability and provenance.
• Make trust visible. Explain who can see information, show where it came from, maintain an audit trail and provide clear routes to correct errors.

A record that helps people get the care they need

The single patient record is an opportunity to make joined-up information a dependable part of care across England. Somerset offers practical experience of live data, shared plans, clinical governance and sustained adoption that can help the national programme succeed.

I want to see that ambition delivered. At Black Pear, we can contribute what we have learned with our NHS partners and learn from others doing the same work. The measure of success should be better-informed decisions and a better experience for patients and the people caring for them.

Read Somerset's first-year eSTEP story for more on the clinical programme behind the technology.