Public attitudes to a Single Patient Record: what does the evidence tell us?

In this evidence review, Spela Godec, Understanding Patient Data’s Senior Research and Evidence Manager, explores what the public thinks about the proposed Single Patient Record, drawing on published research and new survey findings to uncover where support is strongest, what concerns remain, and what will be needed to maintain public confidence.

Key insights

Many people in England already expect and assume their health and care records to be joined up.

Overall, people support the idea of a national Single Patient Record and see clear benefits for secondary use of this information (e.g. planning and research). Support is lower when external organisations are involved and for newer uses of data (AI and digital tool development).

People expect strong safeguards – secure systems, accountability with audit and consequences, transparency of access, and a degree of choice.

Some groups express greater caution about how information may be shared and used.

What is a Single Patient Record?

The Single Patient Record (SPR) is described by NHS England as "a digital record that brings together a patient’s health information in one, secure, easy-to-access place." Announced by the Secretary of State for Health and Social Care in October 2024, the SPR offers a significant opportunity to improve continuity of care and patients’ access to their information. The idea is not new – England has spent years building the foundations for more connected care through Summary Care Records, Shared Care Records, interoperability standards, electronic patient records and increasing digitisation across the NHS and social care system.

But legislation currently before Parliament (the Health Bill) would create the legal framework needed to support the development and operation of a universal national health record. You can read more about the history here: Long Read: The Single Patient Record: what the legislation does – and what it will take to deliver it.

Evidence base: rapid evidence review and findings from Understanding Patient Data's public sentiment tracker

With a few notable exceptions, such as the National engagement on data: cohort 2 report, the available evidence base about the SPR is relatively limited. Most evidence relates to local or regional record-sharing initiatives, or to broader and conceptual questions about data sharing, data linkage and access to health records. It provides important context but does not show how the public would respond to this particular national model in practice.

This document summarises the key insights from a rapid evidence review of published research focusing on topics relevant to the SPR, complemented by empirical findings from UPD's sentiment tracker carried out in early September 2026. The survey data were collected by Kantar on behalf of UPD, with a nationally representative sample of 1,280 UK residents over 16; 1,077 were based in England and were asked about their views about a SPR.

Do people think a Single Patient Record already exists?

Yes, research shows that many people appear to think that joined-up health records do exist already.

Research found that many people assumed that a single national healthcare record already existed. UPD's nationally representative survey of 1,104 adults in England carried out at the end of 2024 found that 61% thought that there already was a single national healthcare record which contains all the data collected about them by the NHS (UPD & Qa Research, 2025).

What this means for the SPR: Wide assumptions that a single joined-up record already exists may create support for implementation but might raise confusion when people learn about how data flow and who has access to them.

Do people support a nationally-coordinated Single Patient Record?

Most people seem to be supportive of a national Single Patient Record.

UPD's sentiment tracker found that support for a single joined-up NHS patient record is consistently higher than for other national data initiatives included in the survey, with 57% expressing support and only 14% saying they do not support it. Deliberative engagement similarly shows that support for a SPR is generally high (NHS England, DHSC and Thinks, 2025).

Research consistently finds support for a SPR when it is seen as improving care, patient experience and outcomes. People frequently cite poor coordination between services, fragmented care and having to repeat information as problems that a joined-up record could help address (Compassion in Dying 2022; NHS England, DHSC and Thinks, 2025). These concerns are reflected in UPD’s sentiment tracker, where 69% identified poor coordination between organisations as a problem, 65% highlighted having to repeat information and 57% said staff being unable to access relevant information from other services was a problem.

What this means for the SPR: While public support for the SPR is high, it is rooted in expectations that it will solve real problems in the delivery of care. In a context of low NHS satisfaction and concerns about the future of services (see British Social Attitudes survey in 2025), people are likely to judge the SPR by whether it will deliver visible benefits for patients and staff. Failure to demonstrate these benefits could undermine confidence over time.

People generally support information being shared when it helps provide better care, but they expect clear limits on who can access information and why.

Research consistently finds support for sharing health information across different parts of the health and care system when this helps professionals provide safer, more coordinated care (NHS England, DHSC and Thinks, 2025). For example, 72% supported sharing information between general practice and hospitals (Health Foundation, 2024), 84% considered it acceptable for the NHS to share information with GPs and hospitals (Yen et al., 2025), and 76% supported sharing identifiable information for direct clinical care without explicit consent (Jones et al., 2022).

Support for sharing information within health and care is likely related to trust in the NHS. NHS England (2024) found that 83% trusted the NHS to keep patient data secure, while around two-thirds reported moderate or high trust in the NHS with their health data (Health Foundation, 2024). Trust is generally highest in organisations directly involved in care, such as GP practices and NHS services.

Our tracker, however, shows a decline in public confidence that the NHS has strong protections in place to keep data secure, from 58% in July 2025 to 49% in September 2026. While differences in question wording and response options mean these findings are not directly comparable with other studies, which tend to report higher confidence in NHS data security, the decline within our tracker remains notable.

Support becomes more mixed when data are linked or shared beyond direct care. Awareness that health and non-health data may be linked is relatively low. NHS England's nationally representative survey found that only 28% were aware that this was taking place (NHS England, DHSC and Thinks, 2026). While many recognise potential benefits, concerns centred on whether linking was secure, accurate and appropriate. Concerns were particularly pronounced among some marginalised groups, who worried about profiling, discrimination or other unintended harms.

Support also declines when access extends to government bodies, commercial organisations and technology companies. For example, only 29% supported the NHS working with technology companies (including AI and analytics firms) in UPD's sentiment tracker. However, rather than expressing blanket opposition, most people weigh potential risks against perceived benefits.

Despite broader research raising concerns about the support for data linking and sharing beyond the health and care, our sentiment tracker shows fairly strong support for different uses of information from a SPR. Most people supported (rather than opposed) using information from a SPR for other uses alongside direct care, with highest support for planning and medical research.

What this means for the SPR: Support for sharing information is strongest when it clearly benefits care and remains within trusted NHS relationships. As the SPR expands access across organisations and systems, maintaining clarity about purpose, access, accountability and safeguards will be essential to sustaining public confidence.

What concerns and safeguarding expectations do people have about a national Single Patient Record?

People's main concerns are unauthorised access, cyber security, overly broad visibility of records, and a lack of transparency about who can access information and why. Most favour role-based access, audit trails, clear consequences for misuse, and the ability to see who has accessed their records.

Concerns about security, cyber-attacks and inappropriate access are consistently identified across health data studies (Health Foundation, 2023; NHS England, 2024; Qa Research & Understanding Patient Data, 2024). In UPD's sentiment tracker, nearly half of respondents were concerned about their health data being accessed by people who should not see it - the most common concern raised.

Concerns about inappropriate access are not hypothetical. A recent investigation found that more than 200 NHS staff had been dismissed and around 2,000 sanctioned for inappropriately accessing patient records over the previous five years, highlighting the importance of robust access controls, monitoring and audit trails (Wise, 2026).

The strongest direct evidence on safeguarding expectations for the SPR comes from National Engagement on Data: Cohort 2. Participants favoured role-based access according to professional need, supported by audit trails, accountability for misuse, transparency about who has accessed records, and patient involvement in decisions relating to sensitive information.

Similar expectations are reflected in UPD's sentiment tracker findings. When asked what would be most important in helping them trust a national SPR, respondents prioritised keeping information private and secure (40%), restricting access according to professional role (31%), clear rules and consequences for misuse (29%), and being able to see who has accessed their record (28%). Notably, only 15% prioritised restricting information solely to their own direct care, suggesting that concerns are often less about sharing itself and more about how sharing is governed.

Around seven in ten (72%) respondents were confident that the health record held about them was accurate and complete. As records become more connected, concerns may increasingly extend beyond security and access to whether information is accurate, up to date and interpreted appropriately.

What this means for the SPR: Evidence suggests that public support for the SPR is conditional on strong governance rather than strict limits on information sharing. Role-based access, visibility of who has accessed records, robust cyber security, clear accountability for misuse, and appropriate protections for sensitive information are therefore likely to be central to maintaining public confidence as the SPR develops.

Do people want to access their own records?

Yes. Most people support being able to access their own health information.

Research consistently finds strong support for patients wanting to access their health records. In a UPD survey with nationally representative sample of 1,104 general public in England, 81% said being able to view their own record was important (UPD & Qa Research, 2025). Current behaviour suggests that access is already relatively common; UPD's sentiment tracker shows 67% have viewed at least part of their health record (albeit the majority just a limited summary).

Some studies suggest that people want a more active role in managing their information (Liminal Space, 2022). For example, a study of electronic end-of-life records found that 63% wanted the ability to update aspects of their record (Compassion in Dying, 2022).

However, accessing health records is not without challenges. Research has found that some patients experience confusion, anxiety or uncertainty when viewing information that is difficult to interpret or that is presented without context (Turner et al. 2023). Some have suggested that patient-facing records should focus on clear summaries and relevant information, rather than simply providing access to all clinical content (NHS England, DHSC and Thinks, 2025).

What this means for the SPR: People generally welcome greater access to their own information, but implementation should consider how records are presented and explained. A layered approach, combining easy-to-understand summaries with access to more detailed information, may help make records more useful while also allowing appropriate handling of particularly sensitive information.

Would a Single Patient Record affect what people tell healthcare professionals?

Probably not for most people, although some groups may be more cautious about sharing sensitive information.

In UPD's sentiment tracker, most respondents said that the proposed uses of SPR data would either make no difference to what they shared with healthcare professionals or would make them more willing to share information. Results were similar when we asked about different uses of information from a SPR.

However, some groups were more likely to say they would share less information in certain scenarios, particularly younger adults, parents and people from ethnic minority backgrounds. Related research on the use of AI, such as Ambient Voice Technology, also impacts how much patients share with their GP, in part due to uncertainties about what happens to the data captured. Only around a quarter of survey respondents felt comfortable talking about sensitive issues like domestic abuse and violence, and mental and sexual health issues, when AI was being used to take notes (Healthwatch, 2026).

What this means for the SPR: Current evidence suggests that a SPR is unlikely to reduce disclosure for most people. However, some groups may be more cautious, particularly when discussing sensitive information. Understanding and addressing concerns about access, privacy and data use will be important to ensure that connected records improve care while maintaining openness and trust.

Do attitudes differ between groups?

Yes, support for a Single Patient Record varies – but remains broadly positive.

UPD’s sentiment tracker found stronger support for a single, joined-up NHS patient record among people from higher socioeconomic backgrounds and among older adults over 55. Some groups appear highly engaged and relatively cautious. For example, respondents from ethnic minority backgrounds were more likely to have viewed their records, but more likely to report having opted out of health data sharing, and more likely to say they would share less information under some SPR scenarios. This suggests that engagement with health data does not necessarily reduce concerns about how information may be accessed or used.

More broadly, attitudes towards connected records appear to be shaped not only by demographic characteristics but also by experiences of healthcare, trust in institutions, confidence in record accuracy, digital inclusion, and concerns about discrimination or stigma. Evidence from community engagement studies suggests that people with poorer healthcare experiences or concerns about fairness and representation may have different expectations and concerns about connected records (UPD, 2026).

What this means for the SPR: There is no single public view on a SPR. While support is generally high, different groups may have different expectations, concerns and information needs. Engagement and communication efforts should therefore avoid assuming that all communities will respond in the same way.

How has the Single Patient Record been discussed in the media?

Discussion of the Single Patient Record remains relatively limited, but wider debates about NHS data use may influence how people think about it.

Media coverage of the SPR remains relatively limited and has largely focused on legislation, implementation plans and stakeholder responses. In UPD's May 2026 sentiment tracker, 40% of respondents recalled seeing news stories about legislation to support the creation of a SPR. Among those who recalled the coverage, more said it made them more supportive of the use of patient data (51%) than less supportive (17%) (UPD, 2026). The coverage did not appear to increase intentions to opt out of data sharing. These findings suggest that media discussion of the SPR may have helped reinforce support for the use of patient data, rather than generating widespread concern.

Public attitudes towards the SPR, however, may still be influenced by wider debates about health data, particularly around governance, commercial involvement, inappropriate access and trust (UPD & Portland, 2026). This matters because people do not always distinguish between different health data initiatives, meaning wider health data stories may shape perceptions of the SPR.

What this means for the SPR: Although the SPR is not currently a highly visible public issue, public attitudes may be shaped by wider debates about health data, particularly around governance, commercial involvement, transparency and trust. Where concerns emerge, they are likely to focus less on the concept of a joined-up record itself and more on who can access information, how decisions are made, and whether appropriate safeguards are in place.

Evidence gaps and unanswered questions

Because the SPR does not yet exist, there is no evidence from real-world implementation, which will be important to gather as plans progress. Other areas that need attention: