Exclusive: 91% of NHS Trusts have an EPR system, but what does that really mean?

By Lina Kurdi | Published: 4-Feb-2025

A Freedom of Information request to NHS England has revealed that 189 out of 208 NHS Trusts in England have an active Electronic Patient Record system

In a recent Freedom of Information request, NHS England revealed to Building Better Healthcare that 189 out of 208 (91%) NHS Trusts currently have an active Electronic Patient Record (EPR) system.

With 91% of NHS Trusts adopting an EPR system, NHS England has surpassed the former Conservative government’s target of 90% adoption by December 2023.

189 out of 208 NHS Trusts currently have an active Electronic Patient Record system

The target was achieved on schedule through NHS England’s Frontline Digitisation programme, which started in 2021, according to NHS England

The Frontline Digitisation programme aimed to enhance the digital capabilities of NHS Trusts by transitioning them from paper-based systems to digital platforms.

EPR adoption played a major role in both the initiative and the broader digitisation of the NHS.

What is an EPR system?

An EPR system is a digital platform that stores a patient’s medical records in one place, including their medical history, test results, medications and treatment plans.

Designed to replace traditional paper records in healthcare, EPR systems provide clinicians with instant access to patient records.

Clinicians are then able to make better decisions as comprehensive information about patients is available in one place.

By streamlining processes, EPRs also aim to reduce errors, improve efficiency and enhance patient care.

An EPR system is a digital platform that stores a patient’s medical records in one place

The goal is to create a fully integrated system where patient records can follow individuals as they move between hospitals and other healthcare settings to ensure continuity of care and reduce duplication of tests and treatments.

EPR systems have been in use across the NHS for the past two decades, according to NHS England.

NHS England helped NHS Trusts adopt an EPR system by providing funding for the EPR rollout, which was implemented at regional and Integrated Care Board (ICB) level.

However, EPR systems were implemented at Trust level.

91% Adoption: A major step forward

The fact that 91% of NHS Trusts now have an active EPR system represents significant progress in the NHS’s digital transformation journey. 

This statistic reflects years of investment, planning and collaboration between NHS England, regional Integrated Care Boards (ICBs), and individual Trusts.

The fact that 91% of NHS Trusts now have an active EPR system represents significant progress in the NHS’s digital transformation journey

EPR systems have already begun to reshape patient care in many parts of the NHS, making it easier for healthcare professionals to access critical information and improving the overall patient experience. 

This achievement highlights the commitment of the NHS to modernise its services and align with global best practices in digital healthcare.

What does ‘active’ really mean?

While 91% of Trusts have an EPR system, the term 'active' raises some important questions. 

  • Are these systems fully functional across all departments? 
  • Are they interoperable, allowing seamless communication between Trusts and other parts of the NHS? 
  • How do they compare in terms of features and effectiveness?

However, the rollout of EPR systems is complex and involves multiple stakeholders, including software providers, IT teams, and frontline staff. 

Each Trust is likely to face unique challenges based on its size, location and existing infrastructure, which is why implementation occurs at Trust level.

Bridging the gap: The remaining 9%

With 19 Trusts still without an active EPR system, NHS England’s work is far from complete. 

These Trusts may face a variety of barriers, including funding limitations, legacy IT systems, or difficulties in staff training. 

With 19 Trusts still without an active EPR system, NHS England’s work is far from complete

Ensuring that every Trust has a fully operational EPR system is critical to achieving the NHS’s long-term goal of a connected, data-driven healthcare system.

At the same time, the NHS must ensure that existing EPR sytems deliver on their promises. This includes addressing issues like interoperability, ensuring systems can 'talk' to one another, and providing ongoing support and training for staff. 

What do the experts think?

Building Better Healthcare reached out to three of the leading EPR system providers to NHS Trusts to share their expertise on EPR adoption in the NHS.

Altera Digital Health

Rachael Fox, Executive VP of UK & EMEA at Altera Digital Health, a healthcare IT solutions specialist, said: “I’m hopeful for a digital-first NHS. The digital investment in the budget is hugely welcomed and we have some digital exemplar NHS Trusts. However, it’s not enough to deliver the digitisation and productivity gains that are truly needed for NHS reform and to keep pace with the digital transformation achieved in other sectors.”

By ensuring clinicians have seamless access to patient records, EPR systems save time, enhance decision-making, and ultimately improve patient outcomes. 

However, while digital progress has been made, challenges remain. As Fox pointed out, the current level of investment, though welcome, is not sufficient to drive the level of digitisation and efficiency needed to match advancements seen in other sectors.

The digital investment in the budget is hugely welcomed and we have some digital exemplar NHS Trusts

Fox added: “To break down the digitisation barriers, fast and flexible implementation approaches are needed in combination with further investment.

“Together they can make innovation accessible to all NHS Trusts and the route to value far quicker. As a critical system provider, Altera Digital Health has an important role in helping the NHS achieve its digital ambitions over the next decade. 

“As we look ahead, my hope is that we’re celebrating more digital exemplars like Liverpool Heart & Chest Hospital, Worcestershire, and Gloucestershire as part of an innovative health system that is cost-effective and proven to manage the demands of modern healthcare.” 

System C

Nick Wilson, CEO of System C, a healthcare digital solutions provider, said:“Strong digital foundations through EPR systems are essential for NHS transformation, but their success must be measured through tangible benefits, not just deployment statistics.”

Wilson highlighted how Artificial Intelligence could enhance EPR systems to further streamline care.

Wilson said: “When implemented effectively, these systems, combined with emerging AI capabilities, can revolutionise care delivery. For example, AI solutions being integrated into our EPR systems are already demonstrating dramatic efficiency gains – saving System C clinicians over 60% of time per documentation task and potentially generating cost savings exceeding £5 million annually per NHS trust.

When implemented effectively, these systems, combined with emerging AI capabilities, can revolutionise care delivery

Wilson also highlights barriers to IT advancement in the NHS, he said: “However, complex procurement processes, clear funding mechanisms, and short-term approaches continue to hinder progress. 

“We need fundamental changes in how funding flows between care settings, greater transparency in how funds are accessed and more agile decision-making powers for Trusts to achieve their targets.

“By fostering closer collaboration between health and social care sectors while maintaining strict accountability for delivered benefits, we can navigate the challenging decisions ahead and ensure a sustainable future for the NHS”. 

Answer Digital

Luke Snelling, Healthcare Sales Lead at Answer Digital, a UK-based digital consultants, said: “Electronic patient records are a foundational aspect of digitising care, and usually the single biggest digital transformation project an individual healthcare organisation will undertake. This is the main reason why in 2025, we have only a handful of hospital Trusts yet to go live with an electronic patient record in England.”

However, Snelling pointed out that some EPR systems run into difficulties. 

Snelling said: “Unfortunately, there are many examples of troubled EPR deployments which run over time, over budget, and don’t deliver the benefits initially intended. Often, these projects aren’t scrutinised sufficiently to enable the mistakes to be avoided in the future.”

As the NHS moves forward, transparency and collaboration will be key to overcoming remaining barriers

On the other hand, Snelling suggests an alternative module approach to the implantation EPR system in NHS Trusts. 

Snelling added: “I believe there’s a different approach to the common ‘big bang’ implementations that often struggle, and that’s incremental deployment of modules as and when a trust is ready to adopt them. 

“Evidence consistently demonstrates that modular projects offer the most cost-effective and flexible approach to modern software development. By prioritising interoperability, integration, and advanced technologies within an EPR, they can improve healthcare delivery.”

The future of digital healthcare in the NHS

Overall, with 91% of NHS Trusts now using EPR systems, the NHS is well on its way to achieving its digital transformation goals.

While challenges remain, the progress made so far reflects the dedication of healthcare professionals, policymakers, and IT teams to modernise patient care.

By sharing lessons learned and celebrating successes, the NHS can continue to lead the way in delivering a healthcare system that is suitable for this modern day and can be adapted in the future

As the NHS moves forward, transparency and collaboration will be key to overcoming remaining barriers and ensuring that all Trusts and all patients benefit from the promise of digital healthcare.

By sharing lessons learned and celebrating successes, the NHS can continue to lead the way in delivering a healthcare system that is suitable for this modern day and can be adapted in the future.

*This information was accurate from December 2024 

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