Interoperability in NHS cancer care: Fixing the digital disconnect

Better system integration and unified patient records can transform NHS cancer pathways, freeing up clinicians to focus on what matters most: delivering life-saving treatment with speed and confidence

“We need fewer, better systems that actually work together.” That was the frank observation from one participant in a roundtable discussion chaired by NHS England's Cancer Innovation Lead, Gillian Rosenberg, as featured in Civica’s report Improving Cancer Pathways. For anyone working in NHS cancer care, the sentiment hits close to home.

Data and technology professionals know that precision medicine, artificial intelligence (AI) and real-time insights are key drivers to deliver better outcomes to citizens, and it seems unthinkable that frontline NHS clinicians still struggle to access the most basic patient information when they need it most. However, for many working in cancer care, that’s exactly the reality.

The IT infrastructure that underpins the NHS cancer pathway remains fragmented and outdated. From primary care to secondary services, patient data is trapped in a myriad of disconnected systems, making continuity of care more difficult than it needs to be. Clinicians spend valuable time searching, re-entering, or requesting information that should be available at their fingertips. In a setting where every minute counts, this lack of interoperability is more than inconvenient but a barrier to timely and effective care.

The cost of fragmentation

The issue isn’t a lack of data. In fact, the NHS generates and stores vast amounts of valuable patient information. But that data is often siloed across different platforms, providers and departments. A GP might record early symptoms in one system, a hospital consultant might log diagnostic test results in another, while a treatment plan sits in yet another, entirely inaccessible record.

This fractured landscape creates duplication, increases the risk of error and places additional pressure on already stretched clinical staff. For cancer patients, delays caused by these disconnects can mean slower diagnoses, postponed treatment decisions and, in some cases, poorer outcomes.

According to Civica’s cancer pathways report, these interoperability issues are a significant source of frustration for healthcare professionals. The report outlines that digital systems across the NHS often lack the ability to share patient records seamlessly, and when they do, the user experience is often clunky and inconsistent.

As another contributor to the roundtable discussion noted, the problem isn’t a lack of tools but that tools don’t connect. “We have the systems. What we lack is the integration that makes them useful.”

The case for unified electronic patient records (EPRs)

One of the key recommendations emerging from the report is the move towards single, unified electronic patient records (EPRs). Rather than having multiple systems attempting to integrate retrospectively, a unified EPR allows healthcare professionals to access the full breadth of a patient’s history in one place.

EPRs offer multiple benefits:

• Faster clinical decision-making, by reducing the time needed to search or request critical information

• Improved safety, by ensuring all clinicians are working from the same up-to-date information

• Reduced duplication, minimising unnecessary tests or rework

• More seamless patient experiences, as individuals don’t need to repeat their story at every stage of the pathway

For cancer care, where patients often interact with several services across the NHS, the value of unified records is even greater. When implemented well, EPRs can become the backbone of more integrated and efficient care.

Barriers to interoperability

Despite the compelling case for better-connected systems, progress remains slow. The reasons are complex, but they tend to fall into three main categories:

1. Legacy systems and digital disparity: Many NHS trusts and GP practices operate with ageing systems that were never designed to integrate with others. Merging these with modern platforms is not always technically straightforward, and the cost and disruption involved can make organisations reluctant to change.

2. Inconsistent data standards: Without national standards for how patient data is structured, recorded and shared, interoperability remains elusive. Different systems speak different languages, making true integration difficult without time-consuming and costly custom development.

3. Procurement and cultural barriers: The NHS has historically procured digital tools at a local level, leading to a patchwork of vendors and platforms. Cultural resistance to change, especially among staff who have experienced previous failed tech rollouts, can also slow down adoption of integrated systems.

Key recommendations

Improving interoperability in NHS cancer care shouldn’t rely on more technology, but on making the existing technology work together better. Here are some of the steps that can help optimise cancer pathways:

1. Prioritise system rationalisation: NHS trusts and ICSs (Integrated Care Systems) need to critically assess their digital estates and streamline where possible. Reducing the number of standalone platforms not only simplifies integration but also makes training and support easier for staff.

2. Invest in open standards and APIs: The use of open standards, like FHIR (Fast Healthcare Interoperability Resources), allows systems to exchange data more easily. NHS England has started mandating interoperability standards for new procurements, but further consistency is needed across the board.

3. Digital frameworks: While local flexibility is important, there is a growing case for national coordination around digital procurement, implementation, and governance. This could accelerate the rollout of interoperable EPRs and ensure that all systems meet a common baseline for connectivity.

4. Focus on user-centred design: Ultimately, the best systems are those that work for clinicians and patients, not just IT departments. Involving frontline staff in the design and implementation of digital tools helps ensure they are intuitive, usable and truly support cancer pathways.

5. Build trust through transparency: Transparency about how data is used, stored and shared is key to building trust among patients and clinicians. Clear communication about privacy, consent and safeguards can help ease concerns and encourage buy-in.

A vision for joined-up cancer care

More than a technical objective, interoperability is crucial for effective clinical practice. This is especially true in cancer care, where swift diagnosis, collaboration among various specialties and continuous treatment are vital. Enhanced data integration has the potential to be revolutionary in this context.

Getting interoperability right won’t just reduce admin burdens and improve efficiency. It will empower clinicians to make faster, more informed decisions. It will give patients confidence that their care is joined up and coherent. And ultimately, it will help deliver better outcomes for the hundreds of thousands of people navigating cancer pathways every year.

Now is the time to act. With the right digital foundations in place, cancer care in the NHS can be faster, safer, and smarter for everyone involved.

Download the report Improving Cancer Pathways: Challenges, Overcoming Barriers and Digital Solutions now.