NHS trusts accelerate EPR implementations with focus on optimisation and safety

NHS trusts are progressing beyond initial Electronic Patient Record roll-outs towards a strategic phase of optimisation, embedding change and realising measurable benefits, amid varied experiences and ongoing challenges.

Over the past year NHS trusts have stepped up large-scale Electronic Patient Record (EPR) programmes, moving beyond procurement into a sustained phase of go-lives, optimisation and work to secure measurable benefits for clinicians and patients. The picture is mixed: several high-profile roll-outs have completed, others have deferred launches to complete data and training work, and a number of trusts are now concentrating on the smaller but harder task of embedding change to realise productivity and safety gains. According to sector reporting, these developments reflect an acceleration in practical delivery alongside familiar teething problems. (Sources: ^[2],^[3])

Many of the recent implementations emphasise meticulous go-live planning. One trust described its approach as an “intensive focus” on tasks such as application build and testing, wait‑list validation, work queues, clinic templates, activity stabilisation, data migration and cutover planning, and on assessing organisational readiness. Boards and programme teams have repeatedly cited the value of extended localisation, staff training and staged functionality to reduce operational risk at launch. (Sources: ^[2],^[3])

Some trusts postponed their launches to secure data readiness and completion of training. A mental health and community trust set out a refreshed timetable and increased programme budget in order to finish structured data cleansing, migration and referral clean‑up before go-live. Other organisations have been explicit that deferral is a pragmatic decision to protect patient safety and avoid costly remediation later. (Sources: ^[2],^[6])

Where go-lives have taken place, early feedback is varied but instructive. A London acute trust went live with an Oracle Health/previously described Cerner system and reported that the roll-out “has been running to time and is largely going as we had expected. We have had problems but have been able to fix most of them as they have come up,” its chief executive said. Boards at trusts that have launched EPMA and integrated records note faster access to single record views on wards, improved visibility of patient flows and safety metrics, while acknowledging that achieving similar benefits in theatres and outpatient settings is more complex. (Sources: ^[2],^[4],^[7])

Several trusts are now quantifying prospective financial and operational benefits as they move from build to optimisation. One major trust has updated internal forecasts for net benefits of its Epic-based programme upward as integration work with patient-facing services continues, and it has begun discussions with national bodies about post-EPR productivity measurement. Other organisations report early reductions in medication errors, improved nursing documentation and faster escalation through sepsis screening captured in digital notes. (Sources: ^[2],^[3])

Optimisation work is being treated as a distinct programme of change rather than an afterthought. Providers are focusing on automating data flows to improve completeness, prioritising changes that affect the greatest number of staff, and establishing clinical leadership for design decisions. Independent advisory sessions with industry experts have repeatedly urged trusts to catalogue and prioritise outstanding change requests, engage directly with frontline teams and adopt iterative fixes that deliver visible benefits quickly. (Sources: ^[2],^[3])

Joint and shared‑instance approaches are gaining traction where regional alignment can reduce duplication and cost. Several pairings and partnerships have prepared memoranda and pre‑procurement engagement to promote common governance, pooled resourcing and shared instances intended to drive clinical standardisation and integrated care pathways. Trusts say such arrangements can support cost-effective procurement and smoother interoperability across acute and community settings. (Sources: ^[2],^[5])

Despite progress, capacity and capital constraints remain barriers for some providers. A regional alliance reported that revised national funding routes and internal deficits have slowed development beyond outline business cases, prompting active work to identify capital and update business cases within the financial year. Other trusts have highlighted the high monthly cost of programme delay and the limited contingency in implementation schedules. (Sources: ^[2],^[6])

Looking ahead, trusts are planning multi-year stabilisation and optimisation phases, supplier-led upgrades and wider patient‑facing capabilities such as portals and NHS App integration. Programme executives and digital leaders repeatedly counsel that the most successful implementations are those that invest in process redesign before aggressive build phases, secure clinical ownership, and maintain sustained engagement with users after go-live. The balance of delivery now shifts from technical deployment to the harder work of transforming how care is organised around digital records. (Sources: ^[2],^[3])

Source Reference Map

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Source: Noah Wire Services