NHS Single Patient Record: Strategic Learnings from Denmark's Digital Health Journey

Lloyd Price
Aug 6
20 min read

Executive Summary

The National Health Service (NHS) is embarking on an ambitious initiative to establish a Single Patient Record (SPR), a cornerstone of its broader strategy to transform healthcare delivery. This report analyses the NHS's vision for the SPR, drawing critical lessons from Denmark's extensive experience with digital health. Denmark, a recognised global leader in eHealth, offers valuable insights into both successful national digital solutions and significant implementation challenges.

The NHS envisions the SPR as a patient owned, system-shared, unified, secure, and accessible record, empowering patients and enabling more coordinated, personalised, and predictive care. This initiative is pivotal to the NHS's strategic shifts from hospital to community care, sickness to prevention, and analogue to digital. However, the approach of building upon existing, disparate systems presents inherent complexities in achieving a truly unified "single version of the truth."

Denmark's digital health journey highlights the foundational importance of a universal patient identifier, such as its Civil Registration System (CPR) number, which facilitates seamless data linkage despite a fragmented underlying Electronic Health Record (EHR) landscape. The success of its patient portal, Sundhed.dk, demonstrates the power of a federated architecture to provide a unified patient view without centralizing all data. Furthermore, the Shared Medication Record (SMR) exemplifies how a focused, nationally integrated solution, built on strong cross-sectoral collaboration and continuous development, can deliver profound benefits in patient safety and treatment quality.

Conversely, Denmark's experience with the Sundhedsplatformen (Epic) implementation serves as a powerful cautionary tale. This large-scale, "big-bang" overhaul was plagued by prolonged productivity dips, inadequate testing and training, data quality issues, and significant user dissatisfaction. This underscores the risks associated with underestimating implementation complexities and neglecting continuous user engagement.

Based on these observations, key strategic recommendations for the NHS include prioritizing a robust, universally adopted patient identifier, embracing a modular and iterative implementation approach, investing heavily in comprehensive data governance and normalisation, fostering deep and sustained cross-organizational collaboration, and ensuring a strong focus on user experience and continuous training. By carefully navigating these areas, the NHS can significantly de-risk its SPR program and enhance its likelihood of achieving a truly transformative digital health future.

The NHS Single Patient Record: Vision, Ambition, and Current Status

The NHS's Single Patient Record (SPR) initiative is a central pillar of its long-term strategy, designed to fundamentally reshape healthcare provision across England. This ambitious program is not merely a technological upgrade but a foundational element intended to facilitate broader systemic reforms.

Strategic Drivers and the "Three Shifts"

The overarching mission of the NHS is driven by three fundamental shifts aimed at transforming healthcare delivery: a transition from "hospital to community" settings, a reorientation from "sickness to prevention," and a comprehensive move from "analogue to digital" operations. The Single Patient Record is explicitly positioned as a pivotal enabler for the "digital shift".

The strategic framing of the SPR as a driver for the "analogue to digital" shift implies that the success of the other two critical shifts – "hospital to community" and "sickness to prevention" – is heavily contingent upon the digital transformation facilitated by the SPR. Without a unified, accessible digital record, efforts to decentralize care or implement proactive, preventative health strategies become significantly more challenging. Moving care closer to home, for instance, necessitates that patient information is readily available and follows the patient across various care settings, such as general practices, home care services, and community clinics. If records remain analogue or are digitally fragmented and siloed within specific institutions like hospitals, this transition is severely hampered, leading to repeated tests, incomplete medical histories, and disjointed care experiences.

A unified digital record directly addresses this by making data accessible wherever and whenever it is needed. Similarly, achieving proactive and personalised care, which is central to the "sickness to prevention" shift, requires a comprehensive view of a patient's health, including lifestyle, demographic, and potentially genomic data, to identify risks and tailor interventions. Analogue or siloed digital data makes such predictive analysis and personalised service offerings impractical or impossible. Therefore, the SPR's ambition to incorporate such diverse data directly supports this preventative health paradigm. This elevates the SPR's strategic importance beyond a mere technological upgrade, positioning it as a foundational prerequisite for broader systemic reform. Any delays or failures in the SPR program could thus have direct, negative ripple effects on the NHS's ability to achieve its broader goals of shifting care models and improving population health.

Core Vision: Patient-Owned, Shared, Unified, Secure, and Accessible

The formal vision for the SPR was articulated in October 2024 by the Secretary of State for Health and Social Care, defining it as: "A single patient record, owned by the patient, shared across the system, so that every part of the NHS has a full picture of the patient". This vision was subsequently enshrined in the 10 Year Health Plan in July 2025.

The core aim is to empower patients with "real control over a single, secure and authoritative account of their data", facilitating "more co-ordinated, personalised and predictive care". For patients, the envisioned benefits are substantial: ending the need to repeat their medical history unnecessarily at every appointment, gaining greater control and transparency over their health records, and enabling easy access to read, update, and share care plans with healthcare professionals. For healthcare professionals, the SPR promises a "clear, unified view of a patient's history," "seamless access" across all care settings (from primary to acute to community), "better-informed decision-making," "reduced administrative burden," and "safer, faster, and more coordinated care" through a more collaborative approach.

A crucial aspect of the SPR's design is its intention to "build on and connect with existing systems – such as Electronic Patient Records, Shared Care Records, and the Federated Data Platform – rather than replacing them". This approach dictates that source systems will retain their role as the clinical system of record. The SPR is intended to be "safe by design," "secure by design," "built to the highest standards of data governance," "interoperable by design" to ensure seamless system integration, and "cost effective". Legislation is planned to place a duty on every health and care provider to make patient information accessible to the patient by default, with an ambition for secure viewing on the NHS App from 2028.

The ambition to achieve a "single version of the truth" and "unify patient information" by "building on and connecting with existing systems" rather than replacing them presents a significant inherent tension. While pragmatic, this approach must contend with the reality of diverse legacy systems, each potentially having different data standards, terminologies, and data quality levels. Merely connecting these systems without rigorous, centralised data normalisation and governance could lead to continued fragmentation at the semantic level, undermining the goal of a truly unified and authoritative record. The market feedback explicitly highlighted "Data normalisation: Making sure data is recorded in a consistent way across all systems is vital" , reinforcing this critical challenge.

Achieving a "single version of the truth" requires more than just technical connectivity; it demands semantic interoperability and rigorous data normalisation. If data is recorded inconsistently across various source systems, merely linking them will show fragmented or even contradictory information, not a unified truth. This indicates a significant architectural and governance challenge. The success of the SPR in delivering a truly unified record will depend less on simply connecting systems and more on the NHS's ability to mandate and enforce stringent data standards, a common data model, and continuous data normalisation processes across all connected legacy and new systems. Without this, the "single version of the truth" might remain an elusive goal.

Current Progress, Legislative Context, and Public/Market Feedback

The SPR program is currently in its "early stages of development," with NHS England having established a dedicated program to deliver it. A Request for Information (RFI) was launched in May 2025 to solicit expert input from the technology market on how best to deliver a secure, user-centred solution that leverages existing infrastructure. Nearly 100 suppliers and organisations responded, providing detailed insights.

Public engagement has been a continuous process, with feedback highlighting several key expectations: proceeding at pace, including an audit trail of access, tiered access for trust, rigorous training in data use and security, patient access as a must, high data security, and transparency throughout implementation and operation.3 The public's desire for confidence that their data will be handled safely and their eagerness for rapid benefit realisation is clear.

Key themes emerging from market feedback include: the essential nature of clear and consistent data standards for interoperability (including the ability to work with older systems), the need for continued engagement with stakeholders to keep development rooted in user needs, the practicality and reduced disruption of a "modular approach" with incremental changes, and the necessity for clarity on data ownership, stewardship, and normalisation.

The market's strong recommendation for a "modular approach" and "incremental changes" directly addresses a common pitfall of large-scale IT projects: the "big bang" overhaul. This approach, as exemplified by Denmark's Sundhedsplatformen experience (detailed later), has often proven problematic due to its high upfront costs, long development cycles with delayed benefits, difficulty in course correction if initial design flaws emerge, high user resistance if the system is not well-received at launch, and single points of failure. By contrast, a modular and incremental strategy allows for smaller, manageable deployments, enabling early user feedback and adaptation, faster realisation of benefits in specific areas, easier identification and correction of issues, and a more agile response to evolving needs. This approach builds user confidence and demonstrates value iteratively.

The NHS's proactive RFI process, and its stated intention to build on existing infrastructure, suggest an early recognition of these risks. If the NHS truly embeds this modular, iterative approach, it could significantly de-risk the SPR implementation, allowing for continuous learning, adaptation, and faster delivery of tangible value, thereby building user confidence incrementally rather than risking a single, catastrophic failure.

Despite recently announced organisational changes within NHS England and the Department of Health and Social Care, the commitment to the SPR remains a national priority.

Denmark's Digital Health Landscape: A Comprehensive Overview

Denmark stands as a prominent example of a nation that has extensively embraced digital transformation in its healthcare sector. Its journey offers a rich tapestry of successes and challenges from which other countries, including the UK, can derive valuable lessons.

Historical Context and Maturity

Denmark is widely recognized as a global leader and one of the forerunners in the use of Information and Communication Technology (ICT) in the health care sector. Its highly digitalised healthcare system is characterized by extensive digitalised workflows and electronic communication between healthcare providers and patients across both primary and secondary sectors. This advanced state of digitalisation is the result of "many years of sustained efforts and ambitious digitalisation strategies" developed for the entire public sector. This long-term commitment has fostered a "strong tradition for joint government collaboration" involving municipalities, regions, and central government, which has been instrumental in creating a robust digital infrastructure and numerous digital self-service solutions.

While Electronic Health Records (EHRs) have been widely adopted by General Practitioners for many years, the development and integration in the hospital sector have historically been more challenging.

Denmark's long-standing digital maturity is not merely a chronological fact but a direct consequence of sustained political commitment and deeply embedded, multi-level governmental collaboration. This suggests that achieving national digital transformation in healthcare is a continuous journey requiring consistent, long-term vision and active cooperation across all administrative tiers (state, regions, municipalities), rather than a series of isolated projects. "Many years of sustained efforts" indicates that digital transformation is an ongoing process that demands consistent funding, policy support, and adaptation over time; short-term political cycles or fragmented funding can easily derail such efforts.

Furthermore, "joint government collaboration" across different levels is crucial for a national system, as healthcare delivery is often decentralised. Without strong collaboration, national digital solutions risk being siloed or poorly adopted at local levels. This collaboration ensures alignment, shared responsibility, and resource pooling. For the NHS, this implies that building comparable digital maturity will necessitate cultivating similar enduring, cross-organisational collaborative frameworks and sustained political will that transcend short-term project cycles, ensuring continuous strategic alignment and operational cooperation across all levels of the health and care system, far beyond the initial SPR rollout, to guarantee its sustained success and evolution.

Key Architectural Principles and National Infrastructure

A cornerstone of Denmark's e-health infrastructure is the Danish Civil Registration System (CPR), which provides a unique digital identification for every citizen. This system, available for over 50 years, allows for seamless individual linkage across various data sources and registries throughout a citizen's life cycle.

The Danish CPR number is arguably the single most critical non-technical foundational element enabling Denmark's advanced digital health system. Its long-standing presence and universal coverage allow for seamless individual data linkage across disparate systems, registries, and care settings. This contrasts with the NHS's current federated approach, which lacks a universal single patient identifier that directly links all records across the entire system. While the NHS aims for a "single version of the truth" by connecting existing systems,, Denmark's experience suggests that a robust, universal identifier is a powerful shortcut to achieving this by enabling data aggregation across disparate systems, even if those systems are not directly interoperable at a technical level. This highlights that a strong, universally adopted patient identifier can compensate for underlying system fragmentation by acting as a master key for data retrieval and presentation, offering a unified view to healthcare professionals and patients alike.

The Danish Health Data Authority plays a crucial role in establishing and maintaining common reference architectures and standards for healthcare IT, publishing these approved standards in a public catalogue to support quality and efficiency. The Advisory Committee on Standards and Architecture further ensures coherence and interoperability in digital solutions within Danish healthcare.

Despite these efforts, the IT architecture has evolved "bit by bit" over two decades, leading to a landscape characterised as "fragmentary". While EHR use is widespread, ensuring national interoperability has proven challenging in itself. The system is decentralised, with two different EHR systems in use across the country, and data is not directly exchanged between them. However, healthcare professionals can view patient EHRs via the E-Journal, including data from other regions, which provides a level of cross-regional data access. The National Service Platform further supports this by providing healthcare professionals across primary and secondary sectors with access to national registers such as the Danish Civil Registration System and the Authorization Register, as well as national services like the Shared Medication Record.

National Digital Solutions: Sundhed.dk and Shared Medication Record (SMR)

Denmark's digital health strategy is embodied by several key national solutions that have significantly impacted patient care and professional workflows.

Sundhed.dk: The National eHealth Portal

Sundhed.dk is the official Danish e-health portal for public healthcare services, launched in 2003, enabling both citizens and healthcare professionals to find patient centred data, information, and to communicate. It provides a wide array of functionalities, including quality-assured health information, access to medical records and medication, and a comprehensive overview of the Danish healthcare system. The portal creates linkages between existing data sources, opens up data sets to new user groups, and facilitates communication between healthcare providers and citizens.

For citizens, Sundhed.dk offers a personalized page (accessible upon identification) that reflects their specific healthcare situation. Here, individuals can view treatments and diagnoses from their hospital patient records, book appointments with their general practitioner (GP), renew prescription drugs, monitor their own drug compliance, survey shortest waiting lists for operations, and even register as organ donors. This empowers patients by offering maximum insight and transparency in the healthcare sector. For healthcare professionals, it offers easy access to clinical information about their patients' medical history. Sundhed.dk plays a crucial role in supporting transparency and patient empowerment, and in providing health professionals with the ability to access patient health data residing outside of local systems and across sectors and boundaries, contributing to more coherent and effective care.

In terms of technical design, Sundhed.dk is based on a federated IT-architecture that integrates with local systems. This means it displays data from more than 120 different sources without storing or duplicating data, ensuring timely, efficient, and secure requests to display citizen health data and high accessibility across various end-user platforms.

Sundhed.dk's success as a patient-facing portal, despite a fragmented underlying EHR landscape, offers a crucial lesson for the NHS App's role in the SPR. The portal's federated model, which aggregates and presents data from numerous disparate sources without centralising or duplicating the data itself, demonstrates that a single access point for patients can deliver significant value and empower individuals even if the backend systems are not fully unified. This approach prioritises user experience and accessibility, building public trust and engagement incrementally. It suggests that the NHS App can begin to deliver on the promise of patient access and control relatively early in the SPR journey, even as the complex work of achieving a "single version of the truth" through data normalisation and deeper interoperability continues in the background. This strategy allows for tangible benefits to be realised by patients sooner, fostering confidence and adoption.

Shared Medication Record (SMR)

The Shared Medication Record (Fælles Medicinkort, FMK) is a national IT solution that provides a comprehensive digital overview of patients' current medicine, prescriptions, and vaccinations for healthcare professionals and patients alike. It stands out as the first national IT solution in Denmark that is fully integrated across all parts of the healthcare system, used by patients and all relevant healthcare professionals.

The SMR ensures that patients' medicine information is updated and accessible for both patients themselves and for healthcare professionals involved in their treatment. This significantly reduces the risk of medication errors, improves patient safety, and increases the overall quality of treatment by providing real-time updates, communication, and information sharing. The system allows doctors to continuously update the current medication order and issue prescriptions directly on the patient's medication record, shifting focus from individual prescriptions to a comprehensive medication order. This has led to fewer medication errors, particularly addressing past discrepancies between municipal medicine information and doctor-updated records.

The implementation of the SMR, initiated in 2009 and rolled out in phases, highlights several critical success factors. Structured cross-sectoral collaboration and responsiveness were key, ensuring that the SMR evolved into a robust common solution. A common national test environment was significant in making the SMR a technically well-functioning solution with high availability and rapid error detection. All access to the SMR is permitted only with a digital signature, placing high demands on infrastructure and security. Furthermore, early discussions clarified the doctor's responsibility regarding the overall medication record, even if they were only responsible for the latest prescription, which addressed professional concerns. Finally, recognising that development is not a one-time effort but requires continuous financing for new needs and functions was crucial for its sustained success and optimisation.

The Shared Medication Record stands out as a prime example of a successful, nationally integrated solution in Denmark, offering specific transferable lessons for the NHS SPR. Its success stems from a focused scope, phased implementation, strong governance, and deep cross-sectoral collaboration. Unlike the broader, more complex EHR overhauls, the SMR addressed a critical, well-defined problem (medication management) with clear, measurable benefits (reduced errors, improved safety). Its phased implementation allowed for learning and adaptation, building support incrementally rather than attempting a "big bang" rollout. The emphasis on continuous development and a robust testing environment also ensured its technical stability and ongoing relevance. This contrasts sharply with the challenges faced by the broader Sundhedsplatformen project and suggests a pathway for the NHS to achieve targeted successes within the larger SPR framework by identifying specific, high-impact areas for national integration that can deliver clear benefits early, thereby building momentum and confidence for broader transformation.

Key Learnings from Denmark for the NHS Single Patient Record

Denmark's journey in digital health provides a dual perspective for the NHS: highlighting critical success factors to emulate and significant pitfalls to avoid in the development and implementation of its Single Patient Record.

Success Factors and Strengths

Denmark's digital health achievements are rooted in several foundational strengths:

Foundational Infrastructure (CPR): The existence of a unique national identifier, the Danish Civil Registration System (CPR) number, is paramount. This system, in place for over 50 years, allows for seamless individual data linkage across various disparate data sources and registries throughout a citizen's life cycle. This universal identifier acts as a master key, enabling a comprehensive view of patient data even when underlying systems are fragmented.
Strong Governance and Standards: The Danish Health Data Authority plays a crucial role in establishing and maintaining common reference architectures and standards for healthcare IT. These approved standards are published in a public catalogue, supporting quality and efficiency, with the Advisory Committee on Standards and Architecture ensuring coherence and interoperability. This centralised approach to standards provides a necessary framework for data exchange.
Patient Empowerment and Trust: A high level of public trust in the handling of health data is a prerequisite for the success of extensive data collection and sharing. Danish citizens have experienced the benefits of digitalisation, leading to a growing expectation for self-service solutions. They have access to logs in the healthcare system, can restrict data access, and grant relatives access to their information, fostering transparency and confidence. This trust is maintained through strong safety measures and the understanding that data generally does not leave the country.
Federated Architecture (Sundhed.dk): The success of Sundhed.dk demonstrates the power of a federated IT architecture. It displays data from over 120 different sources without storing or duplicating the data centrally. This model allows for a single, unified patient-facing portal that provides comprehensive information by drawing from various existing systems, proving that a centralised data repository is not always necessary to deliver a coherent patient experience.
Targeted National Solutions (SMR): The Shared Medication Record (SMR) exemplifies the success of a focused, nationally integrated solution addressing a critical need. Its benefits in reducing medication errors and improving patient safety are clear and measurable. Key to its success were structured cross-sectoral collaboration, a phased implementation approach, and a common national test environment.
Continuous Development & Testing: The SMR's ongoing success is attributed to continuous development and financing, acknowledging that new needs arise and new functions are always required. A robust common national test environment ensures technical stability and rapid error detection.
Digitalised Workflows: Denmark boasts highly digitalised workflows, with 99% of all prescriptions sent electronically to pharmacies and 97% of all referrals to hospitals, medical specialists, and psychologists made electronically. This widespread adoption of digital communication enhances efficiency across the healthcare system.

Challenges and Pitfalls

Despite its leadership, Denmark's digital health journey has not been without significant challenges, offering crucial cautionary lessons:

Fragmented EHR Landscape & Interoperability: Despite a long history of ICT use, the Danish healthcare IT architecture is characterised as "fragmentary". While EHR use is widespread, ensuring national interoperability has proven challenging. There are two different EHR systems in use across the country, and data is not directly exchanged between them, although professionals can view patient EHRs via the E-Journal. This indicates that even with strong national standards, achieving seamless data flow across diverse regional systems remains a complex hurdle.
Sundhedsplatformen (Epic) Implementation Issues: The implementation of Sundhedsplatformen, a joint venture between the Capital Region of Denmark and Region Zealand and the largest IT investment in Danish healthcare history (approximately DKK 2.8 billion), serves as a powerful cautionary tale. Intended to replace outdated systems with a single system for real-time patient data and improved workflow, the project has been "still troubled five and three years, respectively, after the first go-live".
- The business case and implementation process were sharply criticized by an independent auditing institution. A key issue was the severe underestimation of the productivity dip following go-live, which was forecast to last merely three weeks but continued for months, leaving hospitals unprepared.
- Testing and staff training were inadequate and rushed, often carried out on an incomplete system that differed from the final rolled-out version.
- The shift in workflow, where hospital doctors took over data recording previously done by medical secretaries, led to difficulties in treating the same number of patients and significant problems in correctly recording activity.
- Data quality, particularly concerning the medication process, suffered from poor usability and unstable system integrations. An expert committee criticised the slow correction of technical errors and insufficient attention to data quality, as well as the lack of clear targets and stringent follow-up in regional change management.
- User dissatisfaction was high, with 32% of users remaining dissatisfied or very dissatisfied with the system. The experience with Sundhedsplatformen serves as a powerful cautionary tale for the NHS, particularly regarding large-scale, "big-bang" system overhauls. The project's extensive problems — including the underestimation of disruption, inadequate preparation, training failures, data quality issues, and significant user resistance — underscore the inherent risks of attempting a comprehensive, simultaneous replacement of multiple legacy systems without sufficient planning, testing, and continuous user engagement. This strongly reinforces the market's recommendation for a modular approach for the NHS SPR, suggesting that incremental changes are far more practical and less disruptive than a single, massive transformation.
User Adoption and Usability: Beyond initial implementation, Denmark has faced challenges in systematic and ongoing optimization of EHR technology configuration and use. Involving clinicians in EHR optimisation has posed dilemmas for hospital managers, who must balance standardisation with adaptation, and centralised control with local autonomy. Usability issues persist, and while surveys assess adoption, approaches vary, indicating an ongoing need for refined strategies in user engagement and system improvement.
Data Governance & Access: Despite high public trust, challenges exist in data governance and access for secondary use. There is currently no centralised metadata catalogue providing a general overview of health-related data collections and access procedures. Access for researchers can take 1-6 months, and fees vary between data holders. Cross-border sharing of health data also remains challenging, with data generally not leaving the country due to privacy and security procedures.

Conclusions and Strategic Recommendations for the NHS

Denmark's journey in digital health offers a compelling case study for the NHS as it develops its Single Patient Record. The Danish experience underscores that successful national digital transformation is a long-term endeavor, built upon a foundation of sustained political commitment, robust multi-level government collaboration, and a high degree of public trust in data handling. While Denmark excels in providing patient-facing digital services and targeted national solutions like the Shared Medication Record, it has also grappled with significant challenges in achieving comprehensive interoperability across its fragmented EHR landscape and in managing large-scale, "big-bang" system implementations such as Sundhedsplatformen.

Based on these critical learnings, the following strategic recommendations are put forth for the NHS:

Prioritise a Foundational Patient Identifier: While the NHS is building on existing systems, Denmark's Civil Registration System (CPR) demonstrates the immense value of a universal, unique patient identifier. Such a system simplifies data linkage across disparate sources and is a powerful enabler for a truly unified patient view, even if underlying EHRs remain distinct. The NHS should consider a long-term strategy to establish and universally adopt a robust, singular patient identifier that can serve as the master key for all health and care data.
Embrace a Modular and Iterative Implementation: The severe difficulties encountered with Denmark's Sundhedsplatformen highlight the inherent risks of large-scale, "big-bang" IT overhauls. The NHS should heed the market's strong recommendation for a "modular approach" with "incremental changes." This strategy allows for phased delivery of tangible value, continuous learning, adaptation based on user feedback, and faster realisation of benefits, thereby significantly de-risking the SPR program and building user confidence progressively.
Invest in Comprehensive Data Governance and Normalisation: The NHS's ambition to achieve a "single version of the truth" by connecting existing systems presents a substantial challenge due to varying data standards and quality across legacy systems. To overcome semantic fragmentation, the NHS must implement rigorous, centralised data governance, mandate consistent data standards, and establish continuous data normalisation processes across all connected systems. This is critical to ensure that data, once exchanged, is truly unified and meaningful.
Foster Deep, Sustained Cross-Organisational Collaboration: Denmark's digital maturity is a direct result of enduring collaboration across state, regional, and municipal levels. The NHS must cultivate similar enduring frameworks for cooperation across NHS England, individual trusts, primary care, and Integrated Care Systems. This sustained, multi-level collaboration is essential for strategic alignment, shared responsibility, and seamless adoption of the SPR across the diverse health and care landscape.
Focus on User Experience, Training, and Continuous Optimisation: The challenges faced by Denmark in user adoption and post-implementation optimisation, particularly with Sundhedsplatformen, underscore the importance of extensive, relevant, and continuous training for all users. Active clinician involvement in the design and ongoing optimisation processes is crucial to address usability concerns, manage the tension between standardisation and local adaptation, and ensure the system genuinely supports efficient and effective clinical workflows.
Build and Maintain Public Trust Through Transparency and Security: Denmark's high public trust in data sharing is a prerequisite for its extensive data collection. The NHS must prioritise transparency in data handling, implement robust audit trails, ensure tiered access controls, and maintain the highest standards of data security. Clearly communicating these measures and demonstrating the benefits of data sharing will be vital for fostering and maintaining public confidence in the SPR.
Leverage the NHS App as a Central Patient Portal with a Federated Model: Learning from Sundhed.dk's success, the NHS App should be strategically developed as the central patient-facing portal. By adopting a federated IT architecture, the App can provide immediate patient value by displaying aggregated data from various sources, even if backend unification is still in progress. This approach empowers patients early and establishes a single, trusted access point for their health information.
Consider Targeted National Solutions for Specific High-Impact Areas: The success of Denmark's Shared Medication Record demonstrates that focused, nationally integrated solutions addressing specific critical needs can deliver profound and rapid benefits. The NHS could identify similar high-impact areas within the broader SPR vision for targeted national solutions, building momentum and demonstrating value through incremental successes.

By diligently applying these lessons from Denmark, the NHS can navigate the complexities of its Single Patient Record initiative, mitigate potential risks, and significantly enhance its prospects for delivering a truly transformative and patient centred digital health system.

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