Advancing national records management to improve care, reduce cost and scale safely

NHS England faced one of primary care’s longest-standing operational challenges: the manual handling of paper-based Lloyd George patient records.

Around 70 million paper files were held across the country. When patients moved between GP practices, records had to be physically requested, packaged and transported. Transfers could take weeks, and in some cases months, delaying access to clinical history and creating additional administrative burden for practices.

The process was slow, labour-intensive and costly. It relied on physical storage, courier services and repeated handling of sensitive information. As pressure on primary care increased, this approach was becoming increasingly difficult to sustain at a national level.

NHS England needed a secure, cloud-first way to digitise and store legacy patient records, make them instantly accessible to GP practices and support nationwide adoption without requiring changes to existing systems.

Answer Digital, working alongside MadeTech as part of the Hippo Consortium, co-designed and built the National Document Repository.

We worked with NHS England, GP practices and delivery partners to understand how records were used in practice and where delays and cost were introduced. The platform was designed as a zero-integration service, allowing practices to access digitised records without modifying local systems.

The solution supported large-scale, automated ingestion of paper records and embedded information governance by design. Continuous feedback from GP practices shaped development, enabling the service to be delivered within six months and refined based on real operational needs.

The National Document Repository transformed access to legacy patient records across primary care.

Over 400,000 records have been digitised and made available to more than 4,000 GP practices nationwide. The platform can process over 250,000 records per weekend, supporting rapid national rollout.
The service delivers weekly cost savings of around £20,000 to the NHS, with individual practices saving up to £50,000 per year. In one practice, digitisation freed up enough space to convert a records storage room into a treatment room.

Adoption has scaled quickly, with more than 3,000 users accessing the platform in a single week. The National Document Repository has been endorsed as part of the NHS’s strategic digital future, with further use cases in secondary care, prison-based GP services and NHS App integration underway.