With the NHS 10 Year Plan front and centre, and improving NHS productivity a key policy focus, the need to accelerate impactful digital change has never been greater. Digital transformation must deliver results, boosting productivity and clinical outcomes, without compromising care or overstretching resources.
Drawing on over 25 years’ experience in NHS digital transformation, I’ve considered what the Electric Patient Record (EPR) landscape will look like in 2026, and what the key priorities should be for trusts at different stages of their digital journey.
Most trusts now have an EPR, shifting the focus from procurement to optimisation and measurable impact. Some are preparing to change platforms to unlock performance, while a smaller number are embarking on first deployments. Three stages typically define a trust’s position, each with distinct priorities.
Trusts with existing EPR systems
For these trusts, the priority is optimisation: pushing digital maturity to enhance clinical care, safety, and productivity, with a target of 2% annual productivity growth by 2028/29. With Treasury releasing an additional £3bn for optimisation, the national focus is clear: get the best from existing systems, not just buy new ones.
Successful optimisation relies on flexibility, configuration, and strong partnerships between trusts and technology providers—factors that enabled digital-first trusts like Liverpool Heart and Chest Hospital NHS Foundation Trust to achieve HIMSS EMRAM Level 7.
AI can accelerate optimisation, but it should enable rather than distract. Practical innovations such as ambient listening and data-driven patient flow improvements, integrated into EPR solutions, help trusts reach higher productivity and maturity faster.
Trusts without an EPR
For trusts yet to deploy an EPR, the focus is on building strong digital foundations. Transitioning from paper processes and disconnected systems allows redesign of care pathways around patient and clinician needs, supporting proactive, preventative, and personalised care—key ambitions of the NHS 10 Year Plan.
Strong foundations ensure trusts can adopt, test, and refine digital tools confidently while driving productivity improvements. Queen Victoria Hospital NHS Foundation Trust’s first EPR, implemented with Altera, exemplifies this approach: it marked the largest digital change in the trust’s history and laid the groundwork for ongoing transformation.
Trusts looking to change EPR platforms
Trusts seeking new EPR platforms need flexible, modular solutions capable of rapid, safe deployment. Traditional decade-long approaches can be replaced by models enabling go-live in months, delivering measurable benefits early.
At Worcestershire Acute Hospitals NHS Trust, Altera’s phased deployment approach achieved tangible clinical and operational benefits within the first six months, freeing capacity for optimisation, AI integration, and deeper clinical innovation.
Conclusion
The 2026 EPR agenda prioritises optimisation, flexibility, maturity, and measurable impact—key to building a resilient, patient-centred NHS. Trusts must assess where they stand in this evolving landscape and choose partners capable of supporting transformation at pace and scale.
Altera will discuss more of its approach at the stand B30 at Digital Health Rewired from 24–25 March.