Patients at risk of harm over lack of shared access to NHS records

An investigation has found that clinicians may be missing "vital" patient information, owing to limited access to NHS records.

A healthcare professional checks patient records on a computer — The investigation also revealed that GPs have reported instances where they have not been informed of private prescribing, such as weight-loss jabs, which can affect other medications

Limited access to NHS records has resulted in direct patient harm and even death, an investigation conducted by the Health Services Safety Investigations Body (HSSIB) has found.

In the investigation, ‘Online prescribing: opportunities to improve patient safety‘, published on 25 June 2026, the HSSIB found that clinicians may be missing “vital” information about a patient’s health because independent prescribing organisations are not able to see and update patient’s NHS records.

The report cited examples of patient deaths as a result of lack of access, including a patient who died following an overdose from two controlled drugs, morphine, which was obtained through an NHS prescription, and zopiclone, which was purchased online.

In addition, GPs reported not being informed of private prescribing, such as of weight-loss jabs, which might affect regular medication, such as contraceptives, and anticoagulants and cardiovascular medications that may be prescribed respective to weight.

“From the other perspective, independent prescribing organisations told the investigation they had patients who were on weight-loss medications whose blood pressure and cholesterol medications needed to be reduced, but these remained at pre-treatment levels despite having informed the GP the patient was on weight-loss medication through their usual method,” the report added.

The investigation also found that many organisations that provide both NHS and private services use their NHS access to check relevant information on a patient’s GP record when providing non-NHS services.

NHS England staff said they were aware of this and told the investigation “that while this practice was not officially authorised, these organisations should use the access they already had in place, because of the safety risk associated with providing care to patients without accessing NHS records”.

HSSIB recommended that the Department of Health and Social Care (DHSC) should develop a policy and implement a mechanism to enable appropriate NHS patient information to be shared with independent prescribing organisations.

“This is to ensure independent prescribing organisations can access verified patient information, with patients’ consent, to inform prescribing decisions,” it said.

The investigation also recommended that the DHSC should undertake a review to determine an appropriate mechanism for write access to health records for independent prescribing organisations.

“This would inform future developments, such as the single patient record, improve the currency of patient information held digitally by NHS organisations and may remove some burden from general practices,” it said.

Commenting on the report, Malcolm Harrison, chief executive of the Company Chemists’ Association, told The Pharmaceutical Journal: “Private healthcare is an increasingly important route for patients to access care. It provides greater choice for patients and additional capacity alongside NHS services.

“Where patients wish for their information to be shared, both NHS and private providers should be able to do so easily and securely.”

“However, information about a patient’s healthcare should remain under the control of the patient, and individuals should be allowed to decide who can access and share their records,” Harrison added.

Kathie Cashell, chief executive of the GPhC, commented: “We agree with the HSSIB that independent prescribing organisations, including online pharmacies, should have access to appropriate NHS records to improve patient safety. We believe that all pharmacies, including online pharmacies, should have read-write access to a person’s records, so all health professionals have the information they need to make safe and informed decisions about a person’s care and treatment.”

A spokesperson for the Pharmacists’ Defence Association said it agreed that prescribers should be able to access patient records.

“However, widening access to data alone is not sufficient. It must be accompanied by clear professional standards, appropriate clinical checks, and regulatory oversight to ensure that remote or private prescribing models do not compromise the quality or safety of care,” they added.

Henrietta Hughes, patient safety commissioner for England, said: “Online prescribing is outpacing the systems needed to keep patients safe. Without access to all patient records — whether NHS or private — it’s not possible for prescribers to have a clear view of a patient’s full medical history, increasing the chances of harmful drug interactions or inappropriate treatment.

“When care is fragmented like this, it becomes impossible for clinicians to join the dots and that’s when patients are put at real risk. The HSSIB’s recommendations are a positive step forward in mitigating this risk.”

A DHSC spokesperson said: “We welcome this report and will consider the recommendations carefully.

“The single patient record will mean NHS staff can see a person’s full medical history and patients will not have to repeat their story unnecessarily. It will result in safer, more co-ordinated care, with clinicians having the full picture when and where it’s needed.”

In August 2025, the DHSC launched a call for evidence to understand the landscape around private prescribing and medicines supply. The survey closed in November 2025, and the DHSC is currently reviewing the evidence to inform next steps, it confirmed.