The Department of Health and Social Care has published an equality impact assessment examining how proposed legislation for a Single Patient Record will affect people across nine protected characteristics, forming part of the Health Bill currently before Parliament.

The Single Patient Record is intended to give patients control over their own medical data and create one unified record accessible across different care settings. The DHSC states the system will reduce administrative burden on clinicians and improve care coordination, including, in future, with adult social care services. Patients are expected to have access through the NHS App by 2028, covering full medical history, test results, appointment booking, medicines management, and support for long-term conditions.

A national public engagement exercise conducted ahead of the assessment drew approximately 2,200 responses. More than three-quarters of respondents expressed support for the proposals. A separate consultation with 76 participants from seldom-heard groups, including older people with long-term conditions, people from ethnic minorities, and disabled individuals, produced similar findings. Those who used health services frequently said the record could improve continuity of care.

The assessment addresses each protected characteristic in turn. On disability, the DHSC notes that fragmented systems currently result in repeated history-taking, duplicate tests, delayed discharges, and increased patient safety risks. The SPR is expected to have an indirectly positive impact across the population, with those who use services most regularly likely to benefit to a greater degree. Those who are digitally excluded will still benefit from clinicians having access to better information, the department states, though they are less likely to experience the benefits of personal access through the NHS App directly.

Women, who are more likely to use health services and more likely to report longstanding conditions, face a greater cumulative risk from fragmented records. The assessment also raises domestic violence as a specific concern. The DHSC notes that 72.5 per cent of domestic violence victims are women, and that coercion or controlled access to devices could prevent some women from accessing their own records through the App. Existing NHS App safeguarding guidance already permits restrictions to be placed on access to clinical records where required.

For men, the DHSC points to data showing suicide is the leading cause of death among men under 50 in the UK. Men make fewer GP appointments and are less likely to seek help for mental health issues. The department suggests that access to personal health records through the App may encourage greater engagement with care services.

On ethnicity, the assessment cites evidence that some ethnic minority groups report poorer health outcomes and face a higher risk of patient safety incidents. The DHSC also notes that minority ethnic groups are more likely to develop multiple long-term conditions earlier than the white majority population. Digital exclusion, language barriers, and concerns about immigration data being recorded are identified as factors that could limit both uptake and benefit from the system.

The DHSC identifies several implementation risks: dependence on a single provider (vendor lock-in), clinical resistance to data sharing changes, and the need for investment to ensure community pharmacists and paramedics have data access equal to GPs and hospital staff. Additional potential costs include translating records into plain English and integrating data. Overall effectiveness hinges on provider/supplier capacity, interoperability, data quality, and patient trust.

The Central East ICB (Bedfordshire, Luton, Milton Keynes, Cambridgeshire and Peterborough, and Hertfordshire) published a five-year digital strategy prioritizing NHS App adoption. Interweave selected preferred suppliers for infrastructure, care planning, and data aggregation for its vendor-agnostic platform. Australia's 2026 federal budget allocated $598.3 million over two years to improve its My Health Record system.

The DHSC has committed to ongoing monitoring of equalities impact as the SPR develops. NHS England has asked Integrated Care Boards to treat digital exclusion as one of five priorities in their health inequalities work, with further mitigations to be built into the programme over time.

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