Your article on the TPG/Optum UK deal, over the patient record system used by most GP practices in England, highlights a specific issue that is symptomatic of a much bigger problem (Alarm at NHS patient records being put under control of US private equity firm, 27 July). I’ve spent years working across the NHS, both in clinical radiology and in national policy roles, and this deal follows a pattern. Systems holding patients’ most sensitive data keep ending up with a small number of large suppliers.
The real opportunity now is to build on the progress already under way, so that ownership of any single system carries less risk regardless of who holds it. NHS England’s own steps, from guidance on AI-enabled tools to the health bill’s proposed provisions on the single patient record, point in the right direction. What should follow on from that is straightforward: data hosted in the UK, a clinician signing off before anything changes in a patient’s record, and an audit trail that regulators and patients can actually check.
The deeper opportunity is in the market itself. A genuinely competitive market needs suppliers working on open, standards-based systems, so that patient records aren’t trapped behind one vendor’s walls, and information is captured as structured, checkable data.
The NHS has already begun building accountability like this into how it works with suppliers, and there’s real value in going further, applying that same standard consistently to every supplier, wherever they are based, on open interoperability and clear governance. That’s what keeps any single company’s decisions from putting the whole system at risk. I’d rather see energy go into growing that choice, so that the NHS is never again this dependent on so few hands.
Erika Denton
Honorary professor of radiology, University of East Anglia; clinical adviser to AI care partner, Heidi
