Sharing with the wider NHS
A destination being “inside the NHS” is neither sufficient nor necessary for lawful direct-care sharing. The relevant questions are purpose, current care relationship, controller authority, confidentiality, need-to-know access, applicable standards and controls.
Common patterns
| Pattern | Minimum concern | Higher-assurance implementation |
|---|---|---|
| Shared-care record | Role- and purpose-specific views, patient expectation/objection, current identity and access, audit, data quality. | Core content mapping, structured GP data, context-sensitive views, strong authentication, break glass, hazard log and correction feedback. |
| Acute referral/discharge | Applicable transfer/referral standard, correct patient, recipient and timely clinical content. | Structured, coded, acknowledged, reconciled exchange with closed-loop error handling. |
| Community, mental-health or ambulance care | Current care relationship, relevant subset, sensitivity and local context. | Interoperable summaries and granular access rules tested against real workflows. |
| Pharmacy and medicines | dm+d, applicable community-pharmacy standard, accuracy and reconciliation. | Structured two-way medicines/events workflow with clinical-safety monitoring. |
| ICB or regional platform | Controller/joint-controller position per use case; direct-care access separated from planning analytics. | Policy enforcement by purpose, role and care relationship; separated data planes and end-to-end audit. |
The direct-care sharing route, minimum-to-maximum requirement model, sharing route decision workflow, NHS standards applicability register, and clinical safety and security controls must be applied to each use case.
For neighbourhood working, NHS App, Single Patient Record, FDP and digital-by-default proposals, also apply 10 Year Health Plan and digital-first implications. Those programmes do not collapse direct-care, operational/planning and research purposes into one sharing route.
Where the design cites a named Chapter 3 product or promise, use the Chapter 3 analogue-to-digital commitment map to distinguish live feature, limited rollout, roadmap target, future procurement and legislation-dependent capability before selecting a sharing route.
Evidence: SRC-007, SRC-014, SRC-015, SRC-024, SRC-025, SRC-031, SRC-038, SRC-039.