Rickles: Shared care records the ‘Cinderella service of frontline digitisation’

In an exclusive interview with Digital Health News, Lee Rickles has said that shared care records are “the Cinderella service of frontline digitisation” and have struggled to get sufficient funding compared to other digital health initiatives such as electronic patient records. 

The trust CIO and Interweave programme director at Humber Teaching Hospitals NHS Foundation Trust and Yorkshire and Humber Care Record said that shared care records are experiencing difficulty at the moment and the year ahead could be challenging. 

“Shared care records are having a bit of a tough time at the moment, they’re definitely the Cinderella service of frontline digitisation when they get less money than a small district general hospital for funding, and it’s generally capital when everybody needs revenue to fund digital services,” Rickles said. 

He added that shared care records have “never really landed that well as they are owned by the wider community” and “haven’t really found their place”. Rickles believes they “have never really had the same investment and focus as EPRs”, with the case overall “never really landing in the same scale and need as an EPR, roster system or finance system”. 

This is backed up the fact that in NHS England’s latest 2024/25 priorities and operational planning guidance, there is no reference of shared care records or the connected care programme, but plenty of focus on the Federated Data Platform (FDP), EPRs and the NHS App.

Funding challenges 

A key challenge around shared care records for Rickles is the lack of funding for the systems and the resources to make them successful. ICBs are leading ICSs to manage budgets and the benefits for their shared care records, in a period of ICS overspends.  

“We’ve got an environment of ICSs that have got to reduce funding quite significantly, we’ve got overspends. If your shared care record hasn’t landed it can be seen as if there is a lot of this money with no benefits. ICBs are responsible for managing the overall budget in the ICS so they need to be clear what the patient and health professional are getting for the money,” he said. 

“It’s going to be a challenging year for the next 12 months for shared care records. As they are not mandated within the frontline digitisation EPR process, you end up creating a conflict because the funding that should be used by EPRs to reconnect to shared care records and make sure things work aren’t naturally seen as the core of an EPR business case process and procurement,” Rickles explained. 

“We’ve never found the shared care record direction from an NHS perspective after the Local Health Care Record Programme,” he added, and have “struggled to get that direction and travel until we had the first national shared care record summit”.

“Getting the Shared Care Record community together helped to provide a direction of travel for NHS England. A great example of the community driving the strategy is the move to use the NRL to join shared care records together, which wasn’t even on the table before the summit”. This is part of what Rickles believes is a more general issue for NHS England, which he thinks with the reorganisation is “struggling to regain its direction for shared care records”.

He also stated: “On a positive we do get weekly two-way communications from NHS England at the CIO touch base. This is the best communications I have ever had from NHS England on the wider digital agenda. We just need to work on shared care records”. 

Shared Care Record Summit 2024 

Rickles will be co-hosting this year’s summit in Birmingham, 16-17 April, alongside Carl Beet from Birmingham and Solihull Mental Health NHS Foundation Trust.  

The event will showcase local progress of shared care record solutions and also be host to senior NHS England staff updating on the future plans for Connecting Care Records. Rickles said he is “looking forward to it because it is a good thing for the system to learn and share together”. 

The inaugural summit last year proved successful with over 250 attendees and 35 of the 42 ICSs attending to hear positive impacts of shared care record adoption across the country.