Government announces “patient passports” and…

On 21 October 2024, the government announced what it has described as the “biggest national conversation about the future of the NHS since its birth”. A public engagement platform, change.nhs.uk, has been launched to allow everyone over the age of 16 living in England to provide their feedback and ideas for reform of the NHS through a series of different questionnaires. Particular focus is given to those who work in healthcare, for whom separate questions will be asked through the platform.

A consultation or merely an engagement exercise?

As has become commonplace for such largescale exercises, the government is working with independent research agencies to facilitate the work. But perhaps unusually among public consultations, this platform will operate more like a message board or forum, as users will be able to view other people’s responses to certain limited questions, allowing them to vote on other people’s ideas for change. Recent case law has explored a distinction between formal consultations, which come attached with the suite of legal requirements known as the “Gunning” criteria, and less formal methods of engagement, which do not (see e.g. the recent case R (TransActual CIC) v SSHSC [2024] EWHC 1936 (Admin), para 235). Depending on the product and intention of this engagement exercise, there may well be arguments either way as to its legal status.

Back to the future – the 10-year plan, revisited

The public engagement exercise is designed to inform the government’s “10 Year Health Plan” which will be published in spring 2025. The last “10-year plan” was published in January 2019, i.e. six years before the publication of the next 10-year plan.

The government is prioritising three shifts in the plan (all of which, it might be said, could arguably be found in the 2019 10-year plan):

hospital to community;
analogue to digital; and
sickness to prevention.

As part of these shifts, the government has announced it will:

bring forward new neighbourhood health centres, with patients able to see family doctors, district nurses, care workers, physiotherapists, health visitors and mental health specialists in the same place;
create a single patient record (or “patient passports”) summarising all of a patient’s health information, test results and letters through the NHS App; and
explore opportunities smart watches and other wearable tech for e.g. diabetes and high blood pressure.

Patient passports and privacy rights

In relation to the “patient passports”, the Guardian reports the government will bring forward legislation on Wednesday, 23 October to allow patient health records to be available across all NHS trusts, GP surgeries and ambulance services. This appears to be as part of the “digital Information and Smart Data Bill” announced in the King’s Speech in July 2024, although the idea of patient passports was not unveiled at that time.

The idea, of course, is not a new one and raises numerous legal complexities, not least in relation to the protection of the privacy rights of patients. It has been met with criticism by a number of rights organisations, such as Foxglove and medConfidential. It follows a long-running controversy surrounding the contract commenced in November 2023 between the NHS and Palantir, an American software company (see e.g. this campaign by the Good Law Project).

This blog was written by Charles Bishop.