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# National and regional integration

**Public-source findings checked 20 October 2026; proposed Defence implications.** National records, regional sharing, identity, referral, document transport and patient access are separate services. No reviewed source establishes one UK-wide integration contract or blanket Defence eligibility.

The internal [Defence architecture](https://copper-tiger.pages.dev/architecture/index.md) retains record continuity, purpose controls and accountable work. Its associated Integration Platform (IntP) would coordinate two-way exchange within Defence and through agreed external interfaces. Internal sharing requirements do not establish permission for the same external operations. [SRC-220](https://copper-tiger.pages.dev/sources/index.md#src-220)

External services can supply or receive defined information and transactions. They do not automatically own Defence clinical work or replace the internal shared care record.

| Context | Public evidence | Proposed interface and unresolved question |
|---|---|---|
| England: Single Patient Record (SPR) | The policy proposes connecting existing records and shared-care services. The Health Bill was still under parliamentary scrutiny in October; policy milestones are not delivered capability. [SRC-193](https://copper-tiger.pages.dev/sources/index.md#src-193) [SRC-194](https://copper-tiger.pages.dev/sources/index.md#src-194) [SRC-195](https://copper-tiger.pages.dev/sources/index.md#src-195) | Prepare replaceable consume/contribute interfaces. Resolve final law, technical contracts, content, permissions and Defence participation before claiming a route. |
| England: National Record Locator (NRL) | Pointers locate provider-held records; retrieval is separate. API documentation distinguishes beta v3 from production v2.8.0. [SRC-196](https://copper-tiger.pages.dev/sources/index.md#src-196) [SRC-197](https://copper-tiger.pages.dev/sources/index.md#src-197) | Specify pointer publication, search and retrieval separately. Confirm supported document types and the exact version for the use. |
| Scotland: record, front door and platform | Policy and the 2026 CMO report describe related but distinct developments. Production NDP services do not establish complete national-record coverage. [SRC-198](https://copper-tiger.pages.dev/sources/index.md#src-198) [SRC-199](https://copper-tiger.pages.dev/sources/index.md#src-199) [SRC-200](https://copper-tiger.pages.dev/sources/index.md#src-200) [SRC-202](https://copper-tiger.pages.dev/sources/index.md#src-202) | Distinguish citizen access, clinical content and integration. Confirm each service's coverage and external onboarding. |
| Scotland: identity | The demographics service describes CHI access with an internal production qualification and a separate external approval route. [SRC-201](https://copper-tiger.pages.dev/sources/index.md#src-201) [SRC-203](https://copper-tiger.pages.dev/sources/index.md#src-203) | Preserve identifier authority; resolve the applicable CHI permissions and service scope for Defence. An application route is not approval. |
| Wales | ICR is a developing programme. February minutes document business-case work; the annual report describes live national data capabilities supporting selected services. [SRC-204](https://copper-tiger.pages.dev/sources/index.md#src-204) [SRC-205](https://copper-tiger.pages.dev/sources/index.md#src-205) [SRC-206](https://copper-tiger.pages.dev/sources/index.md#src-206) | Assess ICR separately from NDR, clinical portal, medicines and communication services. Later approval, complete coverage and a Defence API are not established. |
| Northern Ireland | May 2025 evidence confirms rollout across five HSC Trusts. FAQs exclude GP/primary care from programme scope and describe selective historical migration. [SRC-083](https://copper-tiger.pages.dev/sources/index.md#src-083) [SRC-207](https://copper-tiger.pages.dev/sources/index.md#src-207) | Preserve PRC continuity separately. Resolve current external functions: the FAQ mixes read-only wording with referral/order functions. Identity infrastructure is a separate concern. [SRC-208](https://copper-tiger.pages.dev/sources/index.md#src-208) |
| Regional sharing | Connecting Care illustrates shared summaries, source documents, delivery and local access agreements. It is one regional example. [SRC-209](https://copper-tiger.pages.dev/sources/index.md#src-209) [SRC-210](https://copper-tiger.pages.dev/sources/index.md#src-210) | Record organisations, coverage, permissions and transition dependencies region by region. Do not infer uniform national content or eligibility. |

## Companion service map

| Function | Public reference and proposed Defence relationship | Boundary |
|---|---|---|
| Identity and registration | England PDS/PCRM; Scotland CHI; Northern Ireland identity services. [SRC-075](https://copper-tiger.pages.dev/sources/index.md#src-075) [SRC-201](https://copper-tiger.pages.dev/sources/index.md#src-201) [SRC-208](https://copper-tiger.pages.dev/sources/index.md#src-208) | Matching and registration are not clinical-record transfer. Preserve namespace and uncertain matches. |
| PRC transfer | GP2GP and nation-specific transfer arrangements. [SRC-007](https://copper-tiger.pages.dev/sources/index.md#src-007) [SRC-082](https://copper-tiger.pages.dev/sources/index.md#src-082) | Specify completeness, attachments, failures, acceptance and open-work reconciliation; no universal Defence route assumed. |
| Referral and advice | England e-RS; Scotland SCI Gateway; Welsh communications routes. [SRC-071](https://copper-tiger.pages.dev/sources/index.md#src-071) [SRC-084](https://copper-tiger.pages.dev/sources/index.md#src-084) [SRC-082](https://copper-tiger.pages.dev/sources/index.md#src-082) | Referral transmission, triage, acceptance, booking and clinical completion differ. |
| Correspondence, results and events | Document delivery, diagnostic reporting and ADT/event services from the [exchange reference](https://copper-tiger.pages.dev/exchange-mechanisms/index.md) and [event model](https://copper-tiger.pages.dev/messaging-and-events/index.md). | Match exact profile, version, cancellation/correction and acknowledgement rules. A document is not a work-completion event. |
| Shared access and summaries | GP Connect, Summary Care Record, national and regional record services. [SRC-022](https://copper-tiger.pages.dev/sources/index.md#src-022) [SRC-125](https://copper-tiger.pages.dev/sources/index.md#src-125) [SRC-196](https://copper-tiger.pages.dev/sources/index.md#src-196) [SRC-209](https://copper-tiger.pages.dev/sources/index.md#src-209) | Assess permitted purpose and operations per service. Access does not grant filing, write-back or occupational reuse. |
| Patient access | National patient-facing services and Defence participation requirements. [SRC-193](https://copper-tiger.pages.dev/sources/index.md#src-193) [SRC-199](https://copper-tiger.pages.dev/sources/index.md#src-199) [SRC-206](https://copper-tiger.pages.dev/sources/index.md#src-206) | Citizen-facing access does not prove professional integration, proxy authority or full historical coverage. |

## Internal capabilities and patient-facing options

The proposed Defence Enterprise Master Patient Index (EMPI) would provide identity matching, identifier linkage and shared demographics. Registration, appointments and patient movements remain in other tools or features. National demographic and registration services may inform those capabilities through approved interfaces; they do not determine the internal software boundaries. Demographic authority and conflict-resolution rules remain TBC. [SRC-212](https://copper-tiger.pages.dev/sources/index.md#src-212)

Patient-facing record services, potentially personal health records (PHRs), are options to explore. The proposed outward flow is source systems → Integration Platform (IntP) → Defence Shared Care Record (DShCR) → IntP → patient-facing services. Patient contributions could return through the IntP to the DShCR, relevant clinical source systems and supporting tools. This is owner-proposed direction, not an NHS-prescribed route or a requirement that every exchange traverse every component. Patient contributions do not automatically amend professional entries or the PRC. [SRC-212](https://copper-tiger.pages.dev/sources/index.md#src-212)

The [Foundations system concepts](https://copper-tiger.pages.dev/foundations/systems-and-capabilities/index.md) distinguish patient-facing services from the continuing PRC. Patient-visible content, proxy access, contribution handling and links to national services remain unresolved.

## Proposed external contract

For each direction specify: intended purpose and population; organisations and roles; consume/contribute/locate/retrieve/launch/notify/refer/transfer operations; patient matching; content and terminology; provenance and corrections; coverage and freshness; security and access; clinical work ownership; failure and escalation; retention and onward use; version and retirement.

Keep source unavailable, permission denied, identity unmatched, content absent and cached content stale visible as distinct conditions. A national service is not presumed reachable during deployment. Permitted local copies, expiry and later reconciliation need explicit agreements and a safe workflow.

Direct-care permissions cannot silently extend to readiness, command, planning or research. The shared-care information-governance framework informs the assessment; it does not settle Defence-specific applicability. [SRC-032](https://copper-tiger.pages.dev/sources/index.md#src-032)

## Discovery and evidence limits

Confirm England's future SPR contract, Scotland's external approval scope, Wales's latest ICR status, Northern Ireland's function-level access and regional transition arrangements. Test cross-nation identity, correction propagation, offline retention and separate-purpose use. Keep allied, overseas and contracted routes in discovery from the outset; this UK research increment does not settle them.

The [validation queue](https://copper-tiger.pages.dev/validation-queue/index.md) names evidence required. Public progress elsewhere is evidence about that service, not proof of Defence deployment. This map remains supplier agnostic.