Chapter 3: from analogue to digital

Decision-use summary

The official heading is “Chapter 3: from analogue to digital — power in your hands”. The chapter is a portfolio of policy commitments, not a single programme, data-sharing purpose or present mandate. It combines patient access, clinical-record exchange, navigation, provider choice, remote care, patient-generated data, research recruitment, app procurement, accessibility, artificial intelligence (AI), staff workflow and a future planned-care platform. Each component needs its own authority, delivery status and assurance decision. SRC-041

This page records the position at 27 July 2026. Use the parent 10 Year Health Plan and digital-first implications page for the current primary-care floor and the sharing route decision workflow for a real flow.

Status key

Words such as “everyone”, “universal”, “full front door”, “soon”, “over time” and “longer-term” are not implementation scope or conformance dates. Plan productivity figures and case-study results are evidence or estimates, not guaranteed national benefits.

Chapter-wide commitments

The Plan’s conclusion says technology will supplement rather than replace human care and that in-person choice will remain for people who prefer or rely on it. That policy safeguard is consistent with, but does not replace, current contractual, equality, accessibility and communication-needs requirements. SRC-041 SRC-047 SRC-052

NHS App commitment map

Advice, choice and access

Knowledge, medicines, measurements and delegated access

Feedback and inclusion

The Plan proposes service, team and provider ratings, storage of feedback, AI-assisted conversion of feedback into actions, and use of ratings in choice, leadership, reward and regulation. This is not one purpose. Collection and response, quality improvement, public display, staff/provider evaluation and regulatory use require separate necessity, transparency, retention, accuracy, moderation, fairness and challenge arrangements. The current roadmap’s work on feedback about messages and 2026 GP Patient Survey access through the App do not establish the wider Plan service. SRC-041 SRC-050 SRC-072

The chapter also promises inclusion by default, tailored information, identification of support needs, British Sign Language and screen-reader support, patient co-creation and community assistance. Apply the current accessibility and equality envelope rather than treating those promises as self-executing specifications: Accessible Information where scoped, WCAG and public-sector accessibility rules where applicable, Equality Act duties, health-inequality duties, user testing and usable offline/assisted routes. The current NHS App accessibility statement records only partial compliance, named defects and separate responsibility for integrated services, so Plan language is not evidence that every journey is accessible. SRC-052 SRC-054 SRC-057 SRC-061 SRC-062 SRC-063 SRC-073

Single Patient Record commitment map

The SPR, FDP, NHS Online and HDRS remain distinct programmes. The unnamed Chapter 3 planned-care platform must not be labelled FDP, an EPR or the SPR without current authoritative evidence. SRC-043 SRC-058 SRC-059 SRC-060

Enabling standards have their own delivery clocks. DAPB4101 is already a scoped section-250 laboratory-to-GP direct-care standard, but the national FHIR/SNOMED transition remains in pilot. NHS England intends testing and assurance to finish by April 2027 before supplier roadmaps and eventual national rollout, with SNOMED PBCL continuing in the interim. The current ISN still says 30 April 2025 while the July 2026 implementation update says that date will be extended without giving a replacement. Do not treat April 2027 as a new conformance deadline or infer that pathology data is already consistently available through the NHS App, SPR or AI services. SRC-028

HealthStore and digital-tool approval

The Plan proposes a HealthStore through which patients could access approved apps, with NICE-evaluated technologies surfaced first, national procurement, some universal tools and some condition- and clinician-recommendation-dependent tools. Current NHS quality strategy says testing is under way and local services are intended to select from nationally approved apps through the marketplace by summer 2027. That is a future target, not a current universal entitlement or completed procurement. Neither source defines “approved” as a single assurance state. SRC-041 SRC-072

NICE’s Evidence Standards Framework helps developers and decision-makers classify and assess evidence for digital health technologies; meeting it does not mean NICE has assessed or endorsed the product, and it does not confer regulatory approval. SRC-066 Software or AI that meets a clinical need may be a medical device depending on its intended purpose and function; this must be determined under the applicable medical-device regime. SRC-067

For each HealthStore product, keep these questions separate:

1. Evidence: is effectiveness supported for the exact population, purpose and version?
2. Regulation: is it a medical device, and is the product/version correctly registered or conformity marked?
3. NHS assurance: which DTAC, DCB0129/DCB0160, DSPT, accessibility, security, interoperability and App-integration gates apply?
4. Procurement and commissioning: who buys, recommends, provides, supports, monitors and pays?
5. Data authority: which organisation controls each collection, disclosure and reuse; what are the Article 6/9 and confidentiality routes?
6. Operations: what happens on error, non-use, withdrawal, supplier failure, model/version change or clinical deterioration?

National procurement, a marketplace listing or a clinician recommendation cannot answer the other five questions. SRC-001 SRC-005 SRC-053 SRC-064

AI and ambient documentation

Chapter 3 uses AI for navigation, diagnostic processing, feedback analysis, clinical-history summarisation, protocol guidance, child-health interpretation, pharmacogenomic advice, documentation and possible care-plan drafting. These are different intended purposes and risk profiles; “AI” is not an approval class.

The most developed current position is ambient scribing. NHS England’s version 2 guidance describes the supplier registry as self-certified evidence supporting local procurement and assurance, not a replacement for them. It calls for a Clinical Safety Officer, DCB0160 safety case/hazard log/monitoring, a DPIA, supplier DCB0129 evidence, appropriate record integration, transparency, staff training, output auditing and user review and approval before further action. It says generative summarisation is likely to qualify as higher-functionality medical-device software, whereas easily verified simple transcription may not. SRC-065

For a GP consultation:

flowchart LR
  A["Conversation and contextual record data"] --> B["Approved ambient product"]
  B --> C["Draft transcript, summary, code or letter"]
  C --> D{"Accountable clinician reviews and corrects?"}
  D -- "No" --> E["Do not action or write to record"]
  D -- "Yes" --> F["Authorised action or source-record entry"]
  F --> G["Patient view, referral or other controlled disclosure"]

The practice or provider remains accountable for the care and the record. Contract separately for audio/transcript retention, supplier subprocessors and locations, training or model-improvement use, deletion, incident evidence, audit access and exit. Reassess when prompts, templates, models, interfaces or downstream actions materially change.

New proactive planned-care platform

The Plan proposes national procurement of an unnamed platform for all NHS provider organisations with:

• remote monitoring feeding the NHS App and SPR;
• care-plan creation and evidence-based scheduling/tracking;
• possible generative-AI care-plan drafts for patient and clinician review;
• SPR visualisation/summarisation and ambient capture;
• multidisciplinary-team workflow and case escalation;
• separately sourced GPS, emergency buttons and emergency broadcast for community staff.

This is a policy and procurement commitment, not a current universal platform requirement. The chapter does not name FDP, prescribe an architecture or data model, specify FHIR/UK Core, allocate controllers, define patient cohorts, set monitoring response times or publish conformance dates. Staff-location features also process workforce data and require their own employment, necessity, transparency, proportionality, access and retention assessment.

Before a primary-care organisation depends on the platform, verify its official identity, procurement status, service specification, relationship to SPR/FDP/EPRs, controller model, data routes, standards, supplier assurance, clinical responsibilities and local availability.

Minimum and maximum Chapter 3 answer

Minimum current requirement

Chapter 3 creates no new current blanket duty to send primary-care data into the wider NHS or other providers. The minimum remains:

1. comply with current law, confidentiality, the executed practice contract, directions and every applicable information-standard notice;
2. retain accessible online, telephone, in-person and assisted routes;
3. define and authorise each patient-access, direct-care, transactional, operational/planning or research flow separately;
4. prove the selected current product, integration, cohort and recipient are live and assured;
5. minimise content, filter by role and purpose, preserve objections/opt-outs, and operate correction, audit, incident and fallback routes.

Maximum defensible readiness

The maximum is not early exposure of the whole GP record. It is an implementation that can adopt each Chapter 3 capability when its authority and delivery gates mature:

• source data are coded, accurate, traceable and correctable;
• identity, proxy/delegated authority, care relationship and role are independently enforced;
• patient access, clinical access, transactions, monitoring, planning and research remain purpose-separated;
• APIs and records use applicable standards with acknowledgement, provenance and safety feedback;
• AI and device outputs remain versioned, monitored, explainable enough for their use and subject to accountable human review;
• non-digital care, accessibility, safeguarding and downtime routes remain first-class;
• every future law, regulation, standard, programme release and product change triggers revalidation.

That is maximum useful conformance and safe availability—not maximum data, automation or connectivity.

Maintained validation gates

Use VAL-013–VAL-019 for the general programme, inclusion, App, assurance and purpose-separation checks. Chapter-specific uncertainties are recorded in VAL-020–VAL-027.