The National Health Service (NHS) in England continues to rely heavily on paper records, spending approximately £240 million annually to store patient files despite longstanding commitments to transition to digital systems. A recent report by The King’s Fund reveals that 209 NHS sites, including hospital clinics and diagnostic centres, still operate exclusively with paper records, while only five trusts have fully digitised patient records.
The £239.5 million cost associated with paper record storage covers expenses such as boxes, folders, filing cabinets, and often renting external storage facilities due to limited on-site space. These paper records encompass a wide range of patient information, including appointment notes, letters, scan results, and diagnostic data.
Efforts to digitise patient records have been ongoing for over a decade. In 2013, then health secretary Jeremy Hunt set a target for the NHS to be paperless by 2018, a goal that was later adjusted to achieving a “paper-free at the point of care” status by 2020. However, these ambitions have yet to be fully realised, with the current NHS Digital strategy laying out a ten-year plan to introduce a unified electronic “single patient record” from 2028. The plan aims to create a comprehensive digital record accessible via the NHS App, allowing healthcare professionals across various settings—such as emergency departments, hospital clinics, and general practitioners—to access consistent and up-to-date patient information.
Sarah Woolnough, chief executive of The King’s Fund, described the ongoing reliance on paper as “a really flagrant example of money being spent where it doesn’t need to be,” highlighting a disconnect between the health service’s digital ambitions and the reality experienced by staff and patients. She also noted that dependence on paper records increases the risk of lost information and inaccuracies, which could adversely affect patient care.
Despite substantial investments in digital infrastructure, including £1.9 billion from NHS England, some trusts continue to maintain mixed digital and paper records. The Department of Health and Social Care emphasises that nearly all NHS trusts already have electronic patient record systems and asserts that the single patient record will offer a more secure, efficient way for health professionals to access medical histories, improving patient safety and reducing repetitive data collection.
Opposition to full digitisation remains among some quarters, particularly privacy advocates and professional groups like the British Medical Association’s GP committee. Concerns focus on patient consent, confidentiality, and the security of sensitive medical data.
The implementation of the single patient record is scheduled for parliamentary debate next month as part of a proposed health bill. Woolnough stressed that successful integration of the digital system depends on continued investment in infrastructure, comprehensive staff training, and building public confidence around data privacy and use. Meanwhile, patient feedback indicates ongoing challenges, with research showing nearly one in four adults reporting inaccuracies or missing information in their records, underscoring the urgency for improved record-keeping methods.