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Estimated impact of the introduction of the single patient record: methodology

Published 22 June 2026

Applies to England

© Crown copyright 2026

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This publication is available at https://www.gov.uk/government/publications/estimated-impact-of-the-introduction-of-the-single-patient-record/estimated-impact-of-the-introduction-of-the-single-patient-record-methodology

Introduction

A press release, 20,000 fewer A&E visits a year thanks to single patient record, published on 1 June 2026 included early estimates of the impact of the single patient record (SPR), as part of announcements around the second reading of the government’s Health Bill in Parliament.

The press release stated that the estimated impacts of introducing SPR includes:

  • up to 20,000 fewer annual A&E attendances
  • 6,000 fewer hospital admissions
  • £20 million annual savings to the NHS
  • 500,000 NHS clinical hours saved each year

The Department of Health and Social Care (DHSC) is committed to demonstrating how SPR can transform care for patients and the NHS over time.

This methodology sets out how figures have been derived, including the data sources, methodologies and adjustments applied. These are illustrative estimates, not based on detailed analysis. We expect to publish updated figures on the impact of SPR as the programme progresses. 

About these figures

These figures are based on initial, high-level modelling informed by NHS activity data, research evidence and clinical assumptions, reflecting the early stage of the programme. Therefore, these figures are subject to change.

Adjustments[footnote 1] have been applied to the raw modelled impacts to account for uncertainty at this early stage of the programme. As a result, the published figures represent approximately 40% of the originally modelled estimates. The figures have also been adjusted to account for the contribution of other NHS programmes, with an assumed attribution applied to isolate the proportion of the impact attributable to SPR.

These figures represent the estimated impact projected at full programme maturity by 31 March 2031.

Fewer A&E attendances

The estimate that SPR will result in 20,000 fewer A&E attendances per year includes:

  • 10,000 through improved community-based management for frail patients
  • 10,000 resulting from improved diagnostic accuracy

Improved community-based management

The figure of 10,000 fewer A&E attendances through improved community-based management for frail patients is modelled on:

  • 2.8 million emergency admissions aged 65 and over in a year[footnote 2] of which 47% are affected by frailty (used as a proxy for attendances)[footnote 3] [footnote 4]
  • minus 600,000 patients receiving virtual care over the year, adjusted for the proportion who would otherwise have needed to attend A&E but avoided doing so because of that support[footnote 5]
  • the result is then adjusted to reflect the reduction in emergency attendances (70%)[footnote 5] and further adjusted using a combined factor to account for programme attribution, confidence and national variation, assumed to be 3.5%

That is, (2.8 million x 47% – 600,000 x 40%) x 30% x 3.5% equals approximately 10,000 fewer A&E attendances.

The estimate was derived from national activity data, adjusted using multiple assumptions (including attribution, confidence and national variation). Data for the number of A&E admissions rather than attendances is used as a proxy.[footnote 2]

Improved diagnostic accuracy

The figure of 10,000 fewer A&E attendances through improved diagnostic accuracy from access to complete patient records is modelled on evidence that electronic continuity of records can reduce diagnostic discordance by nearly 50%,[footnote 6] with a 5% improvement assumed.

The figure is modelled as follows: 28 million attendances[footnote 7] x 5.7% diagnosis error rate[footnote 8] x 5% assumed improvement from complete patient records x 30% assumed confidence level x 50% assumed attribution to this programme equals the modelled estimate of 10,000 fewer A&E attendances.

Fewer hospital admissions

The estimate that SPR will result in 6,000 fewer hospital admissions per year, alongside improved management of conditions such as heart failure and better co-ordination of mental health care, is based on the below.

A&E attendances

As set out above, the model estimates 20,000 fewer A&E attendances each year. To estimate how many A&E admissions may be avoided, an average 23% A&E attendance-to-admission conversion rate[footnote 7] is applied, giving 4,600 fewer admissions each year.

The formula is: 20,000 fewer A&E attendances x 23% conversion rate = 4,600 fewer admissions.

This means the admissions estimate should be treated as a cautious lower bound, as the underlying attendance estimate is itself likely to be understated.

Heart failure

Access to complete patient data enables proactive management and early intervention, preventing avoidable A&E visits. The heart failure figure is modelled on:

  • in 2025 to 2026, 28 million people attended A&E with 6.4 million admitted[footnote 7] (of which around 87% are adults - this data is from 2024 to 2025[footnote 2])
  • 5% of admissions in adults relate to heart failure[footnote 9]
  • 10% of A&E attendances associated with heart failure are modelled as avoidable, as an assumption based on qualitative evidence[footnote 10]

Therefore, 6.4 million x 87% x 5% x 10% assumed reduction x 30% assumed confidence level x 50% assumed attribution to this programme equals the modelled estimate of over 4,170 fewer admissions per year.

Mental health

There are 120,000 emergency admissions annually for mental health conditions.[footnote 11][footnote 12]

Some 14.6% are estimated to be preventable.[footnote 13]

An assumed 10% reduction in these preventable admissions is modelled, reflecting improvements enabled by earlier identification and more co-ordinated care.

Therefore, 120,000 x 14.6% x assumed 10% reduction x 30% assumed confidence level x 70% assumed attribution equals the modelled estimate of over 360 fewer hospital admissions per year.

Conclusion

Combining the A&E, heart failure and mental health modelling above equates to 9,100 fewer admissions per year.

A prudent 30% reduction is applied to reflect national variation, potential overlap between cohorts (and therefore double counting), and the aggregation of independently modelled effects, giving an estimate of the overall admissions impact, resulting in over 6,000 fewer hospital admissions per year.

Financial savings to the NHS

The figure of £20 million annual savings to the NHS is based on:

  • around 237 million medication errors in England per year (2019 figure)[footnote 14]
  • 1.12 billion prescription items dispensed in England in 2019 to 2020 rising to 1.26 billion in 2024 to 2025[footnote 15]
  • an average NHS prescription cost of £8.88, therefore an estimated £11.2 billion in cost for all 1.26 billion prescriptions[footnote 14]
  • the assumption that 10% is saved due to enabling digital transfer of patients’ prescription information[footnote 16]
  • the assumption that SPR delivers a 5% saving, modelled at a 50% confidence level[footnote 1]
  • the assumption that a further 40% reduction is applied to reflect national variation and implementation factors

Therefore, 237 million errors x £8.88 per prescription x 5% assumed reduction x 40% assumed national variation x 50% assumed confidence level equals the estimate of £20 million plus saved each year. 

NHS clinical hours saved

The figure of 500,000 NHS clinical hours saved each year is based on:

  • the assumption that doctors spend 16% of total working time on administrative functions[footnote 17]
  • NHS data indicating even greater impacts when looking at the total clinical staff cohort including doctors, with 33% of clinical time spent on administrative functions[footnote 18]
  • NHS workforce statistics which estimate that there are 150,000 NHS doctors in March 2026[footnote 19]
  • the assumption that there is a 5% reduction in this total administrative time as a result of implementing SPR, and the assumption that this reduction applies to the doctor cohort using the lower of the above estimates for administrative time spent
  • the assumption that 2,080 hours are worked per year based on a 40-hour work week at 52 weeks a year

Therefore, the number of NHS doctors (150,000) x hours worked each year (2,080) x administrative time (16%) x 5% assumed reduction x 50% assumed confidence level[footnote 1] x 50% assumed attribution to programme. This is then further reduced by 20% to account for variations.

This modelling suggests over 500,000 hours of clinical time could be released.

  1. Confidence level adjustments are a standard process of analysing estimates and figures to narrow uncertainty. ↩ ↩2 ↩3

  2. NHS England Hospital episode statistics (HES), Emergency admissions aged 65 and over, April 2024 to March 2025 (accessed February 2026) ↩ ↩2 ↩3

  3. Hertfordshire Care Providers Association (2025) Frailty figures ↩

  4. The NHS Alliance (2024) Supporting people living with frailty ↩

  5. Study in South-West London (2026) (unpublished study) ↩ ↩2

  6. Usher MG and others. Diagnostic discordance, health information exchange, and inter‑hospital transfer outcomes: a population study. Journal of General Internal Medicine 2018: volume 33, issue 9, pages 1,447 to 1,453 ↩

  7.  NHS England A&E attendances and emergency admissions (accessed May 2026) ↩ ↩2 ↩3

  8. Newman Toker DE and others. Diagnostic errors in the emergency department: a systematic review. Comparative Effectiveness Review 2022: number 258 (accessed May 2026) ↩

  9. National Institute for Cardiovascular Outcomes Research (NICOR) (2019) National heart failure audit, 2019 summary report (2017 to 2018 data) (PDF, 1,525KB) ↩

  10. Myhre PL and others. Digital tools in heart failure: addressing unmet needs. The Lancet Digital Health 2024: volume 6 ↩

  11. Office for Health Improvement and Disparities (2026) Adult mental health and wellbeing data (accessed May 2026) ↩

  12. Office for National Statistics (2025) Population estimates for the UK, England, Wales, Scotland and Northern Ireland: mid-2024 (accessed May 2026) ↩

  13. Nuffield Trust (2015) Quality Watch report Focus on: People with mental ill health and hospital use ↩

  14. Elliott RA and others. Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety 2021: volume 30, issue 2 ↩ ↩2

  15. NHS Business Services Authority (2025) Prescription cost analysis - England 2024 to 2025 ↩

  16. Camacho EM and others. Estimating the impact on patient safety of enabling the digital transfer of patients’ prescription information in the English NHS. BMJ Quality & Safety 2024: volume 33, issue 11 (note the £98 million calculated in this article relates to the cost of avoidable admissions, not the cost of reissuing the prescription and/or additional prescription as calculated in this methodology) ↩

  17. Woolhandler S and Himmelstein DU. Administrative work consumes one-sixth of U.S. physicians’ working hours and lowers their career satisfaction. International Journal of Health Services 2014: volume 44, issue 4, pages 635 to 642 ↩

  18. Health Service Journal (HSJ) (2022) Clinicians spend a third of working hours on documentation ↩

  19. NHS England (2026) NHS workforce statistics - March 2026 (accessed May 2026) ↩

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