For our EPR feature series, we take a deep dive and reflect on some of the progress made around EPRs over the last 12 months, focusing-in on implementations, on optimisation and benefits realisation, on future plans, and on insights from the wider health and care sector.
Implementation and go-lives
East Suffolk and North Essex NHS Foundation Trust went live with its Epic EPR in October 2025, with the trust highlighting that its approach to go-live included “intensive focus” on application building and testing, wait list validation, work queues, clinic templates, activity stabilisation planning, data migration, cutover planning, and organisational readiness.
Coventry and Warwickshire Partnership NHS Trust shared a revised digital roadmap with go-live set for January 2026 of its SystmOne EPR implementation, and an additional £1 million in programme costs. The implementation is continuing, with structured data cleansing, migration, and referral cleanup activities ongoing, according to the trust. The decision to defer the go-live to January is to allow the completion of both data readiness and staff training, it continues, with the projected cost also to rise from £3.5 to £4.46 million due to costs associated with training and manual data migration.
The board of York and Scarborough Teaching Hospitals NHS Foundation Trust shared an update on progress around EPR implementation, with overall progress reported as “in line with plan”. Go-live of the first tranche is due to begin on 27 February 2026, including observations, clinical documentation for inpatients, urgent & emergency care, electronic prescribing and medicine administration, and read-only diagnostic results. The second tranche, which contains full order comms, is set to go live on 30 June, 2026, with the third to follow on 30 October.
Barking, Havering and Redbridge University Hospitals NHS Trust went live with Oracle Cerner EPR across its hospitals and other sites including Barking Community Hospital and St George’s Health and Wellbeing Hub, as “the last acute trust in London to go digital”. Plans to introduce the £44 million EPR were first shared in late 2023, with the trust highlighting the importance of collaboration with the team at Barts Health, who completed an earlier implementation of the same system. On the go-live, chief executive, Matthew Trainer, commented: “So far, 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.”
Queen Victoria Hospital NHS Foundation Trust launched its electronic patient record, named “Archie” in honour of surgeon Sir Archibald McIndoe, in November 2025. The trust awarded the EPR contract, worth an estimated £10,631,245.25, in 2024 to Insight Direct, subcontracting services to Altera Digital Health. Implementation work began in 2024, with core elements relating to inpatients, outpatients, electronic prescribing, theatres and minor injuries and reporting modules among those to go live. Taking to LinkedIn, the trust thanked colleagues for being “incredible” in helping to mobilise the project, highlighting the work of more than 120 digital champions in supporting their peers and ensuring seamless integration of the system.
South Warwickshire University NHS Foundation Trust and George Eliot Hospital NHS Trust boards discussed their shared EPR programme, noting a go live in October 2026, the need to progress at pace, and highlighting the potential costs if the programme delays. “The programme has very limited contingency time, and delays to the programme timescale are estimated at a cost of £1 million per month,” the boards highlight. EPR localisation sessions are underway to review the current EPR system and workflows with a view to assessing impact on trust processes, as well as potential clinical and operational risks.
Royal Cornwall Hospitals NHS Trust has placed the total cost of its eCare EPR project at £43 million, with implementation expected to be completed by June 2026. £13.3 million of this figure is reportedly to be spent with the trust’s main software provider. The trust has been working with clinical and operational staff to help develop the system, and is now reportedly in the testing phase, with an expected go-live date in winter. More than 200 subject area experts are helping to provide “invaluable expertise”, whilst there have been 650 sign-ups to become an eCare champion to drive the change forward across the organisation.
A memorandum of understanding for a joint EPR programme has been prepared by Greater Manchester Mental Health NHS Foundation Trust and Pennine Care NHS Foundation Trust, outlining the joint approach to procurement, governance, resourcing, and decision-making. The joint approach is intended to ensure the successful implementation of an EPR solution, providing a consistent and unified patient record, aligning with national NHS digital strategies and regulatory requirements, sharing expertise, and to support “cost-effective resource allocation”.
University Hospitals of Derby and Burton and Chesterfield Royal Hospital NHS Foundation Trusts have introduced Nervecentre’s cloud–native EPR platform. Launched across six hospitals in February 2025, as part of a phased roll-out, this phase focused on deploying mobile capabilities to the hospitals’ emergency departments and inpatient wards. The trusts report that in its first week, the system was used to create more than 435,000 patient notes, to take more than 100,000 observations, and to raise in excess of 137,000 tasks. Almost 90,000 sepsis screening notes were also added in the first 48 hours, potentially supporting early detection.
The iClipPro EPR went live across St George’s, Epsom and St Helier Hospitals, integrating multiple systems across the trusts’ sites, and covering more than 17,000 colleagues with an aim of minimising duplication and streamlining administrative tasks.
The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has completed the roll-out of its Apollo EPR system, which replaces the trust’s current patient administration systems with an integrated digital record. The EPR, which is supplied by System C, has involved the largest single investment the trust has ever made in a tech solution, brining functionality covering the ordering of tests and medications, the remote viewing of results, and an overview of bed use.
Herefordshire and Worcestershire Health and Care NHS Trust has partnered with The Access Group to launch Rio as their EPR system, with the aim to “transform care delivery” across the trust. With the EPR system in place, the trust has noted how they can now “connect multiple systems into one” and take advantage of “enhanced security”, allowing staff to access patient information quickly while also protecting sensitive data.
Optimisation and benefits realisation
Birmingham Women’s and Children’s NHS Foundation Trust’s optimisation of Epic EPR is “critical” to improving clinical workflows, data accessibility, and decision-making, the trust has stated. Work is ongoing to automate data flows from the Epic system to improve data completeness and quality, with a “significant opportunity” to harness health data in support of research and innovation.
Barking, Havering and Redbridge University Hospitals NHS Trust reflected on benefits from its EPR, which went live in November 2025 alongside EPMA, at a cost of £50 million. As well as challenges including “anticipated” performance impacts, the board noted that benefits from the system have been easier to deliver on wards, where time has been freed up for clinical staff to spend with patients; and harder to realise in theatres and outpatient clinics. Those benefits have reportedly improved the ability to track patient flow and safety metrics, with work on organisational resilience, capturing lessons learned, and leadership support set to continue. Having patient data integrated into a single digital record is also expected to help streamline workflows.
Manchester University NHS Foundation Trust’s board shared plans to update the forecasted net financial benefit of its Hive EPR from £340 million as listed at the business case stage, to £390 million. Integration work with MyMFT and the NHS App is ongoing, with the trust sharing that Epic interfacing with the NHS App will be completed in March 2026. The business case for local care organisation digitisation “continues to be developed, as is the case for Epic Infrastructure refresh with both cases expected for review in Q3”. Discussion is ongoing relating to the potential uses of Hive monitoring to help review productivity and effectiveness of system use, and the trust has been approached to work with NHS England as part of a review of post-EPR adoption productivity increases.
The East Cheshire NHS Trust board noted a “smoother than anticipated go-live” of its MEDITECH EPR in June of last year. The joint go-live with Mid Cheshire NHS Foundation Trust introduced phase one functionality including emergency department, patient administration system, theatres, inpatient and outpatient clinical documentation, and radiology requesting. Inpatient electronic prescribing and medicines administration followed shortly after. “This has been a very successful roll out,” East Cheshire states. “The majority of staff have adapted well to the new ways of working and are already realising the advantages of having digital clinical notes including reduction in drug errors, monitoring nursing assessments, clinical documentation in a single place etc.”
Future plans
Mid Yorkshire Teaching NHS Trust shared how advancing its EPR strategy will involve consolidating multiple existing systems into a single EPR platform, “delivered as an organisational change and service transformation programme rather than a digital project”. A two-phase approach will be taken to delivering the EPR by summer 2028, followed by an estimated six-month period for stabilisation.
Progress on the single EPR has been “far slower than expected” at Northern Care Alliance, with changes to NHS England digital funding routes and NCA deficit making it challenging to progress beyond the outline business case. “Work to identify capital funding continues in support of the programme and an updated OBC is due to be presented to the board during this financial year,” it updates. “The team are working with community colleagues to set out a clear strategy for a community EPR which remains a gap in our strategic plans.”
Norfolk and Suffolk NHS Foundation Trust shared progress around the procurement of a new EPR, with the aim to deliver a replacement by spring of 2027. A new EPR programme director is being sought to lead the procurement and implementation process, with responsibilities to establish robust change management, governance, and engagement strategies, and to ensure the programme delivers on its objectives. On the procurement, NSFT outlines plans for the contract with a new EPR supplier to last for five years, with options to extend. The system is expected to bring opportunities to introduce new functionality and services such as a patient portal, to allow patients to manage appointments, review health records, and communicate with their care teams online, it adds.
NHS Humber Health Partnership, covering Hull University Teaching Hospitals NHS Trust and Northern Lincolnshire and Goole NHS Foundation Trust, has announced its selection of the ORBIS U EPR solution by Dedalus. Sharing on LinkedIn, the trust celebrated the “significant milestone” the EPR represents in helping both trusts improve the experience of staff and patients across the Northern and North-East Lincolnshire, Hull and East Yorkshire regions.
The business case to upgrade the AlderC@re EPR system from Meditech Expanse version 2.1 to 2.2 was approved by the Finance Transformation and Performance Committee at Alder Hey Children’s NHS Foundation Trust in November 2025, the trust shares, offering benefits and added functionality across nursing, oncology, labs, and critical care. The upgrade is also expected to improve integration with the patient portal, and facilitate developments with AI and patient-facing digital tools.
Mersey and West Lancashire Teaching Hospitals NHS Trust highlighted an agreement to work on a collaborative EPR re-procurement with Warrington and Halton Teaching Hospitals, with the aim being “a single, shared-instance EPR that delivers clinical standardisation, operational efficiency, and improved integrated care pathways”. Work is underway on pre-market engagement ahead of an expected launch in early 2026.
At The Christie NHS Foundation Trust, work is underway on an outline business case for a new EPR, with procurement of a solution expected to commence in early 2026 to consolidate existing legacy systems and promote integration, and with Deloitte said to be engaged in options appraisal for the new system.
The Royal Orthopaedic Hospital NHS Foundation Trust has selected InterSystems as its electronic patient record partner. The trust is to work with InterSystems to design the system to progressively replace paper-based notes and separate databases with “secure, integrated, accessible digital records”. Implementation planning is now underway and the programme is set to begin in 2026.
2026 go-live dates have been confirmed for the “joint Devon EPR”, in what has been described as “an ambitious programme to transform care for patients and staff across Devon’s acute hospitals and community sites”. The One Devon EPR Partnership is made up of three trusts: Royal Devon University Healthcare NHS Foundation Trust, Torbay and South Devon NHS Foundation Trust, and University Hospitals Plymouth NHS Trust. With Royal Devon having already implemented Epic, University Hospitals Plymouth and Torbay and South Devon’s signing of a contract with the same supplier is said to be “a major step forward in the shared vision to implement a single EPR across Devon”.
Hampshire and Isle of Wight Acute Provider Collaborative has outlined progress and next steps toward the provision of a single EPR across the ICB’s four acute trusts. Progress to date includes process mapping and benefits, the APC shares, noting procurement support has also been secured. Actions for Q1 include completing a further round of pre-market engagement, developing invitation to tender documentation, and beginning the approvals process.
Insights from across the health and care sector
A HTN Now panel discussion exploring EPR customisations for the frontline discussed optimisation, challenges and key learnings from success stories. Panellists included Doctor Stephen Jones, principal clinical psychologist at Sheffield Children’s Hospital; David Wong, associate professor of health data science and health informatics at Leeds University; Mark Simpson, digital innovation leader at Leeds Community Healthcare; and Michael Odling-Smee, CEO at Aire Innovate.
We were joined by experts from Ideal Health for a separate HTN Now webinar, looking to discuss ways to unlock the full potential of an EPR and achieve real, impactful productivity and performance gains through strategic optimisation.. The session looked at ways to work smarter and enhance the user experience in order to support better patient care, delving into what optimisation looks like and the benefits that come from it. Panellists from Ideal Health were made up of Nick Robertson, training & change director; Tara Athanasiou, advisory & strategic practice director; and Kate Mansfield, practice director. They each shared their advice and provided real-world case studies to demonstrate what good optimisation looks like.
Diving into how to optimise your EPR in the most effective way, Nick shared what he considered to be the main areas of focus, starting with identifying which processes need examining first. “A starting point might be looking at your requests for change as there might be some that have been missed because they’re too big to address quickly. Look through this list with a fresh pair of eyes. If you try and fix everything at once, you’re probably not going to fix anything effectively. So be strategic and be specific about what you’re trying to target.”
He emphasised the importance of listening to feedback and talking to staff directly to identify areas that are causing the most frustration. “Focus on the aspects that are going to impact the largest number of staff,” he added. “If there’s something that’s driving inpatient nurses crazy, focus on that and get that fix communicated to make their lives easier.” Nick suggested reaching out to different groups once a month to find out what their unique challenges are, noting that, “people tend to stop logging issues if they’re not getting resolved. So, if you regularly reach out and listen to your staff, they’re more likely to tell you what’s going on.”
For a recent HTN Now session on the topic of EPRs now and in the future, we were joined by digital leaders including Sally Mole, senior digital programme manager – digital portfolio delivery team at The Dudley Group; Keltie Jamieson, CHIO at Bermuda Hospitals Board; and David Newey, digital health expert and executive CDIO. We heard in depth from our panel in terms of their EPR journey, sharing their approach, examples, challenges and lessons learned. We went on to discuss the current position with EPRs, the opportunity, and the current need. Looking ahead, we discussed what the future of EPRs looks like in the short, medium and longer term.
“What I’ve seen work really well is spending about a year before working with your vendor to make sure you’re cleaning up your processes, understanding how you want to take care of patients, so you can actually design the system to do that,” Keltie reflected. “I think a lot of places think the project starts with the vendor, but at that point you’re on a bullet train and it’s very hard to be figuring out how you’re going to do things while you’re madly building, testing, and things like that.”
Ensuring that the EPR is clinically-led is key, Sally told us, “as although the IT team have the technical ability to implement and make changes, it’s the clinical team that need to assess things like impact on other services, and the things that the IT team might not think of in the first instance in terms of clinical safety”. Dudley has always done a clinical safety review after the design and implementation process, she went on, “so we have multiple touch points where we’re designing-out clinical safety risks before we get the the point of implementation”. A key improvement has been the work done to engage with the organisation and make sure the right people are involved, so that the EPR can be owned by there services, and not by IT.
