A senior NHS technology leader has warned that achieving seamless data sharing between primary and secondary care systems remains an “impossible job”, underlining persistent structural challenges in the UK’s digital health infrastructure. Beverley Bryant, chief digital information officer at University Hospitals Dorset NHS Foundation Trust, highlighted the difficulties of integrating widely used GP software with hospital electronic patient record (EPR) systems.
Her comments reflect mounting frustration across the NHS as efforts to create a unified digital ecosystem continue to face technical and organisational barriers. At the centre of the issue is the challenge of connecting primary care systems such as those provided by TPP with hospital platforms like Epic Systems. These systems have evolved independently over decades, often using incompatible data standards and architectures.
Fragmented systems and legacy constraints
The NHS has long struggled with fragmentation in its digital estate. GP systems and hospital EPRs are typically procured separately, resulting in a patchwork of technologies that do not easily communicate with one another. Bryant’s warning underscores how this fragmentation persists despite years of national policy aimed at improving interoperability. While initiatives such as integrated care systems (ICSs) and shared care records have made incremental progress, fully aligning primary and secondary care data remains elusive.
Historically, even basic data exchange between GP and hospital systems has been limited, with information often transferred via documents rather than structured, interoperable datasets. The widespread adoption of large-scale EPR platforms like Epic in hospitals has further complicated integration. While these systems offer advanced functionality within organisations, connecting them with external GP platforms, particularly those using different standards which introduces additional layers of complexity.
Technical and cultural barriers to integration
Experts point to several underlying causes behind the interoperability gap. One major issue is the lack of consistent data standards across the NHS. Although frameworks such as SNOMED CT have been introduced to standardise clinical terminology, implementation remains uneven between primary and secondary care settings. There are also technical challenges. GP systems like TPP’s SystmOne are designed for high-volume, transactional use in community settings, whereas hospital systems such as Epic are built for complex, multi-specialty workflows. Aligning these fundamentally different architectures requires significant customisation and ongoing maintenance.
Beyond technology, organisational and contractual barriers play a role. Data governance rules, supplier agreements and differing local priorities can all slow progress. Integration often depends on collaboration between multiple stakeholders, including NHS trusts, GP practices, software vendors and regulators, each with their own incentives and constraints. Bryant’s characterisation of the task as “impossible” reflects not just technical difficulty, but also the scale of coordination required across the health system.
Implications for patient care and digital strategy
The inability to seamlessly share data between care settings has direct consequences for patients. Clinicians may lack access to complete medical histories, leading to duplicated tests, delays in treatment or increased administrative burden. Improving interoperability is therefore a central objective of the NHS’s long-term digital strategy. Programmes such as the Frontline Digitisation initiative and investments in shared care records aim to bridge the gap, enabling clinicians to access consistent patient information across organisational boundaries.
However, Bryant’s comments suggest that current approaches may not be sufficient to overcome entrenched challenges. Some experts argue that more radical solutions, such as national platforms, stricter interoperability standards or greater central oversight may be required. At the same time, there is growing recognition that interoperability is not a one-off technical fix but an ongoing process. As new technologies, including AI-driven diagnostics and remote monitoring tools, are introduced, the need for robust data integration will only intensify. For now, the NHS faces a difficult balancing act: continuing to invest in advanced digital systems while ensuring they can communicate effectively across the wider health ecosystem. Bryant’s warning serves as a reminder that without addressing the foundational issue of interoperability, the full benefits of digital transformation may remain out of reach.
