The single patient record: the assurances given

HEALTH BILL · SINGLE PATIENT RECORD

Ministers have given a series of assurances about how the single patient record will protect patients — who may see a record, what will be logged, how sensitive information will be handled. This page records each one, in the Minister’s own words, against what the Bill itself requires. The pattern is consistent: the assurances are welcome, and almost none of them is on the face of the Bill.

An assurance given at the despatch box binds the Minister who gives it for as long as they hold office. A provision in a statute binds whoever comes next, and a patient can rely on it. That is the difference this page tracks. We will record an assurance as written into the Bill as promptly as we record one left outside it. Every entry names where it was said, so anyone can check it against the record.

How we read these

On the face of the Bill — the safeguard is written into the statute and binds whoever administers the record.

Assured, not enacted — a Minister has given the assurance in Parliament, but nothing in the Bill requires it. It rests on the word of the Minister of the day.

Deferred — the point was raised and the Government has undertaken to respond, but has not yet done so.

Assured, not enacted

Access restricted to authorised users, with an audit trail of who has looked

Said: Baroness Merron, Minister, House of Lords, Second Reading, 13 October 2026
What the Bill says: Nothing requires it. New section 250E does not require role-based access or an audit trail; the only safeguard on the face of the Bill is a duty to “have regard to” the need for adequate safeguards.
Status: Assured, not enacted

Replying for the Government, the Minister said access to patient information would be restricted to authorised users, with an audit trail of who has accessed a patient’s data, in order to clamp down on the serious transgressions that have been seen of late. This is the central safeguard patients ask for, and the assurance is welcome. But it was given from the despatch box, not written into the Bill: it binds this Minister and not her successors, and no patient could enforce it. Putting it on the face of the Bill would not frustrate a single stated policy — it would secure the one the Government says it already intends.

Role-based access, clinician redaction, and proxy access on consent

Said: Ministers, House of Commons, Committee and Report stages, 2026
What the Bill says: None of these appears in the clause.
Status: Assured, not enacted

As the Bill passed through the Commons, Ministers gave assurances that access would be role-based with an audit trail, that clinicians would be able to redact particularly sensitive information, and that proxy access would be set out in regulations granted on the patient’s consent. Each is welcome. None of them appears on the face of the Bill; all are left to regulations that Parliament may approve or reject as a whole but can never amend.

Raised, not yet answered

The common-law duty of confidentiality

Raised: Lord Patel, crossbench, House of Lords, Second Reading, 13 October 2026
Government response: The Minister undertook to reply to Lord Patel on the point, rather than answering it in the debate.
Status: Deferred

Lord Patel told the House that he intends to bring forward an amendment on the common-law duty of confidentiality, so that it continues to apply to those who handle information shared through the record. The Minister said she would come back to him on it. The question it raises — whether the power to set aside the duty of confidence is confined to putting information into the record, or extends to who may then see it — is therefore live and unresolved as the Bill goes into Committee. Update, 20 October 2026: Lord Patel has now tabled that amendment (Clause 52): it would require the regulations to provide that processing complies with the obligation of confidence owed to the patient. The Government’s substantive response is awaited at Committee.

Also recorded

On secondary uses, the Minister said the Bill creates no new legal gateway to health data for purposes such as planning and research, and does not enable data to be collected for them, but that it carries a savings provision under which the record may be a source of data for those uses where a separate legal basis already exists, relying on existing data-protection law (House of Lords, 13 October 2026). This governs how the data may later be used; it is not a control the patient holds over who, inside the system, may see their record.

Amendments tabled to put safeguards in the Bill

At Committee stage, members may move to place on the face of the Bill what the assurances above leave to regulation. As at the running list of 23 October 2026, the relevant amendments to the single patient record clause stood in the name of Lord Clement-Jones — new clauses providing for a patient right to opt out, for an access log the patient can see together with an annual independent audit reported to Parliament, and an amendment that would remove the regulation-making power to set aside an obligation of confidence — and of Lord Kamall and Earl Howe, requiring an assessment of the NHS’s readiness before the first regulations are made. On confidentiality, Lord Patel (crossbench) has since tabled an amendment requiring the regulations to provide that processing complies with the obligation of confidence owed to the patient, and Baroness Hollins has tabled a new clause protecting confidential psychological therapy records from routine disclosure without the patient’s consent. Further amendments have since been tabled — Baroness Barker would exclude sexual and reproductive health information from the record without the patient’s consent and put anonymous sexual-health services on a statutory footing; Lord McColl of Dulwich would admit regulated non-NHS providers subject to role-based access, audit and safeguards for particularly sensitive information; and Lord Markham would require a data-minimisation review. The specific National Data Guardian formulation, limiting the set-aside to the supply of information into the record, has not been tabled; the amendments above take a different route to the same end. Elements of the access architecture are now beginning to appear in others’ amendments; what remains untabled is a patient-controlled restriction of sensitive information as a general right, confidential access for a competent young person, and protection against inference from appointment and prescribing data. We record these as tabled, not as carried; amendment papers are provisional and are consolidated before debate.

Sources

Statements in the House of Lords are from the Second Reading debate of 13 October 2026 (House of Lords Hansard, corrected report). Statements attributed to the Commons stages were made during the Bill’s Committee and Report stages in the House of Commons in 2026. Statutory references are to new sections 250E and 250F of the National Health Service Act 2006, as inserted by the Bill as amended in Committee (Bill 131).

Changes to this page
15 October 2026 — Page created, recording the assurances given on the single patient record at Second Reading in the House of Lords and during the Commons stages, against what the Bill requires. Linked from the single patient record hub, the House of Commons and House of Lords pages, and the Updates feed.
17 October 2026 — Added a note of the amendments tabled to the single patient record clause for Committee, as at the running list of 16 October 2026.
21 October 2026 — Updated the amendments note to the running list of 20 October 2026: recorded Lord Patel’s confidentiality amendment (now tabled) and Baroness Hollins’s clause on psychological therapy records.
24 October 2026 — Updated to the running list of 23 October 2026: recorded Baroness Barker’s sexual and reproductive health amendments, Lord McColl’s provider-access clause, and Lord Markham’s data-minimisation review.

Eden Openly is an independent clinical health-education publication. It receives no funding from, and has no commercial relationship with, any provider of gender-related healthcare, any pharmaceutical company, or any supplier of NHS digital systems. See our statement of independence. Statutory text checked against the Health Bill as amended in Committee (Bill 131), new sections 250E and 250F of the National Health Service Act 2006. Corrections and queries: [email protected].