Re: "the vast and disparate NHS"
Having trudged through all the comments to this piece, can I thank this correspondent for reading what was said and understanding the implications (unlike nearly every other comment in this thread).
If this set of policies gets anywhere near reality, then this is the first time (that I can recall) that Government is seriously contemplating setting out (or nailing their colours to the mast of) a set of data interchange standards - rather than mandating this company or that software.
This is, of course, what they should have done this the first time around. By defining data interchange formats and the data to be transferred, it really could open up competition and innovation. This is what Government should be doing, not picking and choosing software for the clinical users.
Existing players will be dragged (probably kicking and screaming) into compliance and they will have to shape up or go under. Having seen the lack of capabilities and UX design of some of the "market leaders" in this space, I can only hope that some enterprising SMEs will take the incumbents on and show them how it should be done.
P.S. NHS number as a unique key - who'd have thunk it?