Digital Passports for NHS reforms

Accessibility and Accountability

Health Secretary Wes Streeting has shared his plans to follow through on one of his three pledged actions to transform the NHS. The Health Secretary proposes ‘patient passports’ via the NHS app to take the institution from ‘analogue to digital’. Patients can access their own medical records and share their details with GPs, secondary care teams and ambulance services.

Currently, there is no single point of access for patient records, which creates barriers between primary and secondary care services. Professionals in each service need access to full patient records, to avoid delays in assessment and treatment. If tests are duplicated, this also adds additional costs to treatment.

Continuity of care is well evidenced as being necessary to good care, but it is also important because it facilitates humane care that builds continually towards an agreed-upon outcome as each professional builds on clear actions and notes made by health care professionals in medical passports.

The layer of accountability a patient passport could add by creating a clear trail of actions and information updated by medical professionals would be welcome. With clear trails of action and treatments, it is easier to ascertain who is responsible for any missed actions before it is too late. The continuity of patient passports would also foster clarity and help medical professionals contribute to a clear health plan.

Integration and Individuality

We need to integrate health care. Mental and physical health are not separate, and even for those of us fortunate enough to be without any chronic condition, recent decades have seen stress become a pandemic, and the mental impact has real and tangible effect on general health.

A lack of integrated care and support services for residents and participants across our services means multiple issues become compounded. These issues feel insurmountable as one statutory service pushes them to another. Policies such as those that apply to dual diagnosis create siloes, as each service has criteria that preclude people from the other.

Any form of siloed and fragmented practice and the institutionalised culture and mentality created amongst teams designing and delivering services is dehumanising and distressing for patients. Dignified support needs to address the whole picture of a person’s health. This whole-person approach also facilitates individualised treatment plans, which are more likely to be successful in achieving good health outcomes.

When viewed as part of the big picture of changes needed to improve health services, patient passports can help support the shift from fragmented care to integrated. SIG’s residents and participants have shared experiences of being denied access to their records and the overwhelming difficulties of repeating their story, as well as their needs and challenges at every access point in service pathways without any assurances they will gain the support they need.

For the patient passport to be as transformative as it would need to be to contribute to a person-centred healthcare system, it needs to incorporate the scope of a personalised treatment plan so that all professionals with access must work together toward an agreed health outcome. For this to be equitable for all levels of support and to be sustainable in the long term, the patient passport will need to have the capacity to join up with local authorities and wider care systems. Safety and privacy are an immediate concern with increasing access to personal data and information. Recent hacks and many historic data breaches in the NHS demonstrate that investment into digital safety needs to be the focus before any innovation is possible.

Patient Passports to Hold All Medical Records

Raje Ballagan-Evans, Policy and Impact Manager