England’s national CCIO sets out a vision for integration

NHS England’s chief clinical information officer (CCIO) has stressed a national commitment to increased interoperability and integration, even as any restructures take place.

Alec Price-Forbes was speaking as part of the integrated care keynote session on day two of Digital Health Rewired at the NEC in Birmingham on 19 March 2025.

The practising consultant rheumatologist, who was appointed national CCIO in September 2024, said there was a “need to think differently about being data being usable, actionable and accessible information and not just read only, but read/write”.

“Fragmented silos are not going to allow us to interoperate as a health and care system to realise the potential we have,” he added.

Asked about the possible future of NHSE’s work on application programming interfaces (APIs), which are crucial to building integrated systems, he expressed optimism.

Price-Forbes said there are 3,000 to 4,000 staff within the NHSE Transformation Directorate who provide a frontline service for the NHS as well as a supplier/manufacturer and safety assurance role.

“That expertise does not exist in the Department of Health and Social Care,” he added.

The strong need for data sharing and integration was underscored by Gemma Peters, chief executive of Macmillan Cancer Support.

Characterising the organisation as a “safety net”, she said it is receiving huge demand “from people with cancer who are falling through the gaps in the system”.

Those gaps are often caused through poor administration and data sharing.

“Administration feels like something that technology should be really good at targeting.

“It’s a massive driver for patient anxiety and one of the biggest influences in whether patients describe their care as good,” Peters said.

She added: “The system, for reasons I fully understand, is very focused on survival and not as focused as they should be on patient experience.”

The possible benefits of getting it right were illustrated by Grace Smith, UK healthcare director at Nortal, which has provided much of the widely-admired e-health and e-government set up in Estonia.

The key, Smith said, was a standard data layer.

“In Estonia it is mandated to sign up to same data exchange, which means there is a unified patient record across the entire system.

“Every GP will have test results from a private specialist in their system automatically; a paramedic will be able to access your entire clinical record within about 30 seconds and if you’re diagnosed with a chronic condition, you will automatically be enrolled for the benefits to which you are entitled.”

Speakers acknowledged that there cannot be an entirely like for like comparison between Estonia and England.

Clearly Estonia is a much smaller country and set up its system from scratch following its separation from the Soviet Union. However, its level of integration is one for which national leaders are clearly striving in England.

“We need to fix the digital infrastructure, to modernise our data platforms and to transform patient experience through the NHS App,” said Price-Forbes.

Ultimately, he spoke of moving towards “a single unified patient record that is accessible, secure, reliable and interoperable and provides benefit to the patient and clinician”.