Potential Target Audience: Executive Decision-Makers, Fund Holders, Policy Teams, Procurement Executives
Purpose: To outline critical considerations for selecting electronic patient data system suppliers that align with NHS privacy, safeguarding, and operational requirements.
Function: This document equips leaders with practical criteria and probing questions to assess supplier readiness, ensuring electronic patient data systems uphold the NHS’s dual mandate: protecting privacy while enabling safe and effective care delivery.
Executive summary
Procuring electronic patient data systems within the NHS demands a delicate balance: systems must ensure rigorous data privacy and compliance while also enabling safeguarding duties and integrated, effective patient care. This briefing highlights legal, operational, ethical, and technical factors essential for procurement decisions. By applying the enclosed supplier questions, executive leaders can mitigate risk, reinforce public trust, and ensure procurement aligns with NHS values.
Key takeaway: Procurement should be accompanied by an Equality Impact Assessment and structured supplier evaluation process to ensure legal compliance, interoperability, and accountability across all system components.
1. Introduction
The NHS’s digital transformation relies on secure, interoperable electronic systems for patient data management. However, increased cyber threats, complex multi-agency safeguarding obligations, and evolving legal requirements (e.g., UK GDPR, Data Protection Act 2018) create a triad of challenges: data privacy, patient protection, and care efficacy.
Poor system design or supplier selection risks:
- Legal liability: ICO enforcement actions for non-compliance.
- Patient harm: Data leaks, failure to flag safeguarding concerns, exarcebating inequalities.
- Operational failure: System incompatibility or downtime.
- Workforce disempowerment: Training gaps, poor user interface, inequitable access to training.
2. Key Considerations for Supplier Selection
A. Legal and Regulatory Compliance
- UK GDPR / Data Protection Act 2018: Lawful processing, transparency, breach notification.
- NHS Data Security and Protection Toolkit (DSPT): Mandatory data security assurance.
- Safeguarding Vulnerable Groups Act 2006 / Mental Capacity Act 2005: Flagging, protecting, and supporting at-risk individuals.
Questions for Suppliers:
- How does your system demonstrate GDPR compliance (e.g., audit trails, encryption)?
- Have you completed NHS DSPT assessments or worked with NHS clients?
- How are safeguarding features integrated without excessive data sharing?
- What support do you provide for ongoing staff training and legal updates?
- Have you conducted or supported Equality Impact Assessments?
B. Privacy by Design and Default
Systems must embed data protection and minimise exposure.
- Technical: End-to-end encryption, pseudonymisation, role-based access.
- Organisational: Regular training, breach response, policy compliance.
- Ethical: Opt-out models, patient consent tracking, transparency.
Questions for Suppliers:
- What encryption standards and access controls are embedded?
- How is patient consent captured, updated, and recorded?
- Can anonymised data be reliably separated for research purposes?
- What audit mechanisms track and restrict inappropriate access?
C. Safeguarding Integration
Effective systems support rapid identification of safeguarding risks without overexposing sensitive data.
- Children: Integration with Child Protection – Information Sharing (CP-IS).
- Adults: Risk flagging and communication with social services.
- Mental Health: Secure protocols aligned with the Mental Health Act 1983 and Mental Capacity Act 2005.
Questions for Suppliers:
- How does your system interface with CP-IS or similar frameworks?
- What controls prevent over-disclosure or unauthorised access to flagged data?
D. Interoperability and Data Sharing
- NHS Spine compatibility: Ensures alignment with NHS national infrastructure.
- Cross-system sharing: Open APIs for GPs, hospitals, social care.
- Avoid vendor lock-in: Modular design and open standards (e.g., HL7 FHIR).
Questions for Suppliers:
- Can you demonstrate integration with NHS Spine and common EPRs (e.g., Epic, Cerner)?
- Are open standards like HL7 FHIR fully implemented?
- How do you ensure long-term system adaptability and flexibility?
E. Cybersecurity and System Resilience
- Preventative: Pen testing, zero-trust architecture.
- Responsive: 24/7 monitoring, breach containment.
- Recovery: Uptime guarantees, backup systems.
Questions for Suppliers:
- What certifications do you hold (e.g., ISO 27001, Cyber Essentials Plus)?
- What is your typical recovery time following a ransomware incident?
- How often are audit logs reviewed and by whom?
F. Cost vs. Compliance Trade-offs
- Total Cost of Ownership: Consider training, licensing, and compliance overheads.
- Compliance ROI: Minimises breach risk, supports audits, and protects reputation.
Questions for Suppliers:
- Provide a five-year cost model with compliance-related expenses detailed.
- Can you provide examples of reduced breach incidence from your NHS implementations?
3. Recommendations for Decision-Makers
- Prioritise Modular Systems that can adapt to post-Brexit and evolving digital standards.
- Pilot with Safeguarding Teams to test alerts, usability, and clarity.
- Demand Transparency in embedded AI or risk stratification tools—assess for algorithmic bias.
- Conduct Equality Impact Assessments during procurement and implementation and follow-up reviews.
- Scrutinise Third-Party Chains to confirm subcontractors meet NHS standards.
- Establish Accountability Protocols for vendor misperformance or legal breaches.
4. Conclusion
Robust patient data systems are the backbone of modern NHS care, yet their implementation must be grounded in compliance, ethics, and equity. Structured, values-driven procurement can prevent harm, maintain legal compliance, and promote public trust. Leaders must go beyond technical performance and hold suppliers accountable to the NHS’s core purpose: to care, protect, and serve.
Glossary of Terms
| Term | Meaning |
|---|---|
| UK GDPR | United Kingdom General Data Protection Regulation |
| DSPT | Data Security and Protection Toolkit |
| CP-IS | Child Protection – Information Sharing |
| EPR | Electronic Patient Record |
| FHIR | Fast Healthcare Interoperability Resources |
| ISO 27001 | Information Security Management certification |
| Equality Impact Assessment | A process to assess how a policy or project affects different groups in society (reference protected characteristics under the Equality Act 2010) |
Reference Materials
- NHS Digital (2023). Data Security and Protection Toolkit.
- Information Commissioner’s Office (2023). Guide to GDPR.
- National Cyber Security Centre (2023). Cloud Security Principles.
- UK Government (2018). Data Protection Act.
- The King’s Fund (2022). Digital Transformation in the NHS.
- Care Quality Commission (2023). Using Technology to Support Care.
King Advisory 
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