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NHS Digital Records UK 2026 — EPR, Shared Records & Interoperability Guide
Complete guide to NHS digital records in the UK — Electronic Patient Record (EPR) implementation, shared care records, FHIR interoperability, NHS Spine integration, SNOMED CT, and digital records software.
85% of NHS trusts have an EPR as of 2026. NHS England targets 100% EPR coverage by 2026 and shared care records in all 42 ICSs. This guide covers EPR, shared records, and interoperability.
NHS EPR Requirements
| Requirement | Description | Mandatory By |
|---|---|---|
| Core EPR | Clinical documentation, orders, results | 2026 |
| E-prescribing | CPOE, drug interactions, eMAR | 2027 |
| Structured clinical documentation | SNOMED CT coded | 2026 |
| NHS Spine integration | PDS, SCR, GP2GP, e-RS | Mandatory |
| FHIR R4 APIs | Interoperability standard | 2026 |
| NHS App integration | Patient access to records | 2026 |
| DSPT compliance | Data security and protection | Annual |
| Mobile access | Clinician mobile access to EPR | Recommended |
Shared Care Record Architecture
- Data sources: GP, hospital, community, mental health, social care, ambulance
- FHIR APIs: Standardised APIs for data exchange between systems
- NHS Spine: Central infrastructure for patient demographics and record pointers
- Record locator: Shows what data is available from each source
- Viewer: Single interface to view records from all sources
- Access control: Role-based access with audit logging
- Real-time: Data updated in real-time across all systems
NHS Interoperability Standards
| Standard | Purpose | Mandatory |
|---|---|---|
| SNOMED CT | Clinical terminology | All NHS systems |
| dm+d | Medicines and devices | Prescribing systems |
| FHIR R4 | API interoperability | All new systems |
| ICD-10 | Disease classification | Coding and reporting |
| OPCS-4 | Procedure classification | Surgical coding |
| HL7 v2 | Legacy messaging | Existing interfaces |
| CDS | Commissioning data set | SUS submissions |
| PRSB | Professional record standards | Clinical documents |
Frequently Asked Questions
- What is an NHS EPR (Electronic Patient Record)?
- An EPR is a comprehensive digital patient record system used in NHS trusts. It includes: clinical documentation, e-prescribing, order communications, results, imaging, nursing documentation, and care plans. 85% of NHS trusts have an EPR as of 2026. NHS England targets 100% EPR coverage by 2026.
- What is the NHS Shared Care Record?
- The Shared Care Record allows authorised health and care professionals to view key patient information across organisations — GP, hospital, community, mental health, social care. It uses NHS Spine and FHIR APIs for real-time data sharing. All 42 ICSs must have a shared care record by 2026.
- What is SNOMED CT and why does it matter?
- SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) is the mandatory clinical terminology standard for all NHS systems. It provides standardised codes for diagnoses, procedures, and clinical findings. SNOMED CT enables interoperability, analytics, and consistent clinical coding across the NHS.