The ability to collect and share clinical data in real-time and with common meaning is crucial to high-quality, sustainable healthcare. While interoperability through a regional or national Health Information Exchange can reduce costs, minimise readmissions and avoid medication errors, a lack of information poses a significant risk to patient safety and makes high-quality, coordinated care challenging to achieve. In the UK, Sustainability and Transformation Partnerships (STPs) are evolving into Integrated Care Records, which then come together to form a Local Health Care Record or LHCR. An LHCR is made up of five or six Integrated Care Systems sharing patient data, to create a regional health information exchange. With much work taking place to facilitate patient information sharing, what can be done at an individual NHS Trust Level?