Adam Coombes, Product Owner – HealthStore®, returns with his take on why a Clinical Data Repository is key for the NHS’ Single Patient Record strategy. In his usual, unique and humorous style, Adam uses the analogy of a rock/music concert to make his point. Much like any great concert, the SPR will rely heavily on the unseen road crew that works behind the scenes to make the headline act shine – especially following NHS England’s recent clarification that the SPR will not be a national data lake, but a federated, standards-driven layer for access. Ultimately, for Adam, it’s all about how patient data is managed, used, and leveraged for the betterment of care delivery and healthcare operations, locally and nationally. Over to Adam…
A practical foundation for the Single Patient Record
Every few years the NHS unveils a big digital vision, and many of us have been around long enough to have the T-shirt and some interesting memories. This time, the headline act is the Single Patient Record (SPR) – the promise of a single, accurate, up-to-date view of a person’s health information, wherever they enter the system.
It’s hard to argue with that. Anyone who’s spent time working with Trusts, or who’s ended up needing care away from home, knows exactly why it’s needed. But we all know that every headline act’s performance relies on backstage operations and infrastructure; the sound, the lighting, the kit, and the people who make everything work. Even the best band is only as good as the road-crew that built the stage, ensured the wiring was safe, and tuned the guitars. And the SPR is no different. Behind the national ambition for a viable Single Patient Record sits a need for dependable, well-structured patient data. I believe that’s exactly where a Clinical Data Repository is the right tool for the job.
The SPR’s core promise is simple: give clinicians and patients a single, trusted version of the truth. Not a “best guess”. Not “please ring radiology”. Not “the system’s down so can you tell me your date of birth again, please?”
The role of a Clinical Data Repository (CDR), like BridgeHead’s HealthStore®, is to ingest clinical data (such as documents, imaging, labs, notes, scans, etc.) from hospitals’ legacy and live systems, giving organisations a coherent, patient-centred view without waiting for every EPR, PACS and other healthcare application in the country to reach nirvana.
I’ve said it before: it’s the digital equivalent of the ‘central library’, complete with translation service, index cards, and a librarian who always knows when the good stuff’s been misfiled.
This aligns perfectly with the recent national guidance on the SPR. On a recent Digital Health webinar entitled: Exploring the Single Patient Record; Ming Tang, Chief Data and Analytics Officer, and Interim Chief Digital and Information Officer, NHS England, stated “What [the SPR] isn’t is a massive data lake. What we’re really trying to do is federate.” She also explained, “The vision [for the SPR] is to make sure that we are able to connect existing systems, be that EPRs, shared care records, and other platforms, so that clinicians and patients can have a view of the longitudinal record in a trusted way.”
Interoperability without the drama
Most national programmes talk a lot about standards: FHIR, DICOM, HL7, OpenEHR. All are fantastic until you meet real-world hospital systems that only ‘half-speak’ them, or speak a dialect last seen in 2003 (or earlier! EDIFACT or PMIP. READ codes anyone?).
The HealthStore CDR’s whole design mandate is: if your system produces data, we’ll take it in, store it in a safe, structured way, and make it usable – creating the locally governed, high-quality data layer required by the SPR (as well as integrating with other platforms, such as the FDP).
It means NHS Trusts and ICSs don’t need a perfect digital estate. They can start with what they have, knowing the messy wiring gets tidied up behind the scenes.
Point-of-care reality: clinicians need one place to look
One thing SPR, Shared Care Records, and regional portals agree on: clinicians don’t have time for five (or more) logins followed by a ‘treasure hunt’ to find all of the relevant information they are looking for. Ming Tang went deeper, saying Because of the difficulties in getting a longitudinal record across the piece, often we make diagnoses or we have missing information where a clinician would have make a different choice. That’s a problem area we are trying to solve [with the SPR].”
That’s where the HealthStore CDR comes into play – working alongside systems like the EPR, clinical portal, imaging viewers; fitting neatly into existing workflows so that users see a joined-up patient record without having to know where all of the data came from. That’s a huge enabler!
Feeding the ecosystem: the Single Patient Record and the FDP
This is the part some people forget. The SPR is not replacing Shared Care Records. Shared Care Records are not replacing the SPR. And neither of them replaces or are replaced by the FDP.
They are all layers, and important ones. Here’s my take:
- Shared Care Records give regional care teams visibility today
- The SPR aspires to a more unified, national pattern of access and consistency
- FDP aims to knit data together (locally and nationally) for operational insight and decision-making.
All three depend on local organisations being able to supply standardised, durable, governed data as their fuel – and that’s the HealthStore CDR’s sweet spot. It’s the data foundation that takes a cacophony of dissonance and helps turn it into a three-layer harmony without forcing Trusts to refactor two decades of clinical systems.
Why does this matter now for the NHS?
Because the future NHS is supposed to behave like one team around the patient.
You can’t do that with half a record here, a scan over there, and an outpatient letter locked in someone’s NAS drive (not allowed, but it happens!). And don’t even get me started on the paper legacy that is far from resolved (if memory serves me, the original date for the NHS to go paperless was 2018!). But all are eminently solvable with a CDR.
Systems like the HealthStore CDR make the Single Patient Record actually deliverable by:
- clearing the technical debt out of the way
- making legacy data safe and accessible
- providing a stable archive for data that outlives the systems that created it
- supporting both operational care and future analytics and AI initiatives
- giving organisations a way to contribute meaningfully to national programmes without needing a decade-long digital strategy, and without assuming their data must be centralised nationally.
The CDR – the road crew helping the SPR take centre stage
The NHS doesn’t need more declarations about transformation. It needs infrastructure that quietly makes those declarations achievable. A robust Clinical Data Repository, like BridgeHead’s HealthStore, is a vital component of this infrastructure – one of the rare things that helps everyone at once – CIOs, clinicians, shared care teams, regional ICSs, imaging networks, national platforms, and yes, patients.
Think of the CDR as the ‘road crew’. Rarely seen, absolutely essential. The team that ensures the SPR can step confidently into the spotlight and deliver a world-class, globally recognised ‘headline performance’. And if the NHS wants the SPR to truly become that internationally celebrated headline act, it needs the right backstage infrastructure in place – starting with a modern, capable, clinically-oriented CDR.
If any of my musings resonate, or you have a different view, I’d love to hear your perspective. You can email me: adam.coombes@bridgeheadsoftware.com or you’ll find me on LinkedIn here.
Adam Coombes is Product Owner for BridgeHead’s HealthStore® Clinical Data Repository. His goal is to enhance care delivery by enabling healthcare providers to create a safe, available, and complete clinical history for patients and make it easy to move data in and out of HealthStore, as and where needed.
Adam is an established Business Analyst, Product Owner, and self-confessed ‘physics geek’. For the last 15 years, he has worked with clinical and technical teams to develop solutions that improve patient outcomes.
If you would like to learn more about BridgeHead’s interoperable Clinical Data Repository, HealthStore®…
