Bringing in single patient record to cost GP practices more than £5m

The cost to GP practices of introducing the single patient record in England is more than £5m, according to a Government impact assessment.

And the paper drawn up by the Department of Health and Social Care (DHSC) and published last week, implies these costs will not be reimbursed. nor will any small businesses or practices be exempted from using the new medical record.

The cost calculations for bringing in the SPR legislation cover 5,837 practices at 2026-2027 prices and includes familiarisation costs, administration costs and onboarding costs.

An estimate has also been made for a total of 373 private GP practices (non NHS-funded), which comes to £332,000.

The SPR formed part of the NHS Modernisation Bill, announced in the King’s Speech last week, and is central to the aims of the Government’s 10-year plan.

The DHSC paper has set out that it will ‘be available to every person who has visited an NHS health professional in England and will initially cover data from primary and secondary care, expanding over time to include services such as adult social care.’

The SPR will contain a patient’s medical history from from birth, including (but not limited to):

• diagnoses
• physiological data (such as blood pressure, heart rate)
• medical imaging
• laboratory results
• treatments and procedures
• prescriptions and medications
• personal care plans
• key primary and secondary care NHS interactions.

Patients will be able to access it through the NHS App.

Overall, the total transition cost of the introduction of the record to health and care providers in its first year is estimated to be £32.8 million, with a range taking into account lower cost scenarios and high scenarios (due to the uncertainty of details) of £10.2 million to £55.1 million.

In all, a move to the SPR will affect 43,857 organisations, including NHS trusts, independent hospitals, GP practices, dental practices (private and NHS), community pharmacists, care homes (private and public), health and care IT suppliers and more.

A new single IT system will not be built but instead existing data systems used by healthcare professionals be harmonised, meaning clinicians will be able to access the SPR through their existing clinical systems,

Proposed legislation will enable the health secretary to require or authorise providers and their IT suppliers to share health and adult social care into the SPR. It will also require or allow providers to receive data from the SPR (including patient uploaded data) back into clinical systems. Providers will have to update clinical systems to reflect changes to the SPR.

However, the DHSC has said the Parliamentary process will address concerns voiced by the BMA around security and patient confidentiality. It will also include a public forum ‘for making the case for the benefits to public and professionals of the SPR’.

In terms of cost, these are largely illustrative, ‘as potential SPR solutions are still at proof-of-concept stage’, the report warns.

The breakdown for GP practices is as follows:

–Familiarisation costs for year 1 only covering staff time required for organisations to understand the new obligations and how they apply – £2.745m. It’s been estimated it will take 4 hours of senior managers’ time to achieve this at micro and small organisations with up to 49 staff; 8 hours of senior managers’ time at medium organisations, with between 50 and 249 employees; and 12 hours at large organisations.

–Administration costs for year 1 only (covering updating best practices, communication and training material needed to bring the organisation in line with the legislation and support successful completion of new obligations) – £2.367m. Costs have been based on using a STEM professional to undertake this activity. It’s been estimated that 10 hours’ administration time will be required for a micro or small business; 20 hours for a medium organisation; and 30 hours for a large organisation.

For onboarding costs, it has been assumed that GP practices will not bear these directly as ‘the SPR technical solution will be designed to integrate with existing architecture with minimal additional resource needed and will not make additional demands on providers to digitise’.

However, there will be costs for IT suppliers and these are expected to be passed on to health and care providers through higher fees in contracts or one-off charges, the analysis has warned.

Finally, since no decision has been made as to how the legilsation will be enforced, no costs have been attributed to this as yet.

The DHSC has indicated only that the costs of ‘this legislation on micro, small and medium businesses are recognised’. It added that the ‘burden of familiarisation costs will be mitigated by the issuance of guidance notes’.

‘These notes will provide tailored information and advice which will be adequate to support compliance with legislation. This is particularly helpful for smaller businesses, reducing the time required to understand the legislation and navigate the changes needed.

‘More widely, the NHS has experience of programmes like this, the lessons of which can be drawn upon to improve the experience for business. For example, the proof-of-concept work is considering how the SPR technical solution can be delivered in a way that supports all sizes of business, including health and care providers and IT suppliers to keep technical onboarding costs to a minimum.’

Responding to the NHS Modernisation Bill which has introduced the SPR, RCGP president Professor Victoria Tzortziou Brown said: ‘We are encouraged by efforts to modernise the NHS and improve the way information is shared across the health service. Done well, this has the potential to improve patients’ experiences of care and reduce fragmentation between services. But any move towards a Single Patient Record must be carefully considered and evaluated, and include robust safeguards to protect patient confidentiality and ensure public trust.’

Management in Practice has asked the DSHC for comment.