One in seven trusts still using paper-based patient records

An investigation has found that 27 NHS trusts have yet to implement an electronic patient record, despite a push by government for full digitisation

30th May 2022 about a 3 minute read
“Trust leaders know that it’s vital to get EPRs right but they are delivering this while overstretched staff are working flat out to tackle backlogs and deliver care to patients as quickly as they can.” Miriam Deakin, director of policy and strategy, NHS Providers

Twenty-seven NHS trusts in England, or one in seven, do not have a trust-wide electronic patient record (EPR) system, according to research by HSJ.

While some of these trusts have EPRs in individual departments, they are still largely relying on paper records. All the trusts are outside London except Barking, Havering and Redbridge University Hospitals Trust and the Royal National Orthopaedic Hospital Trust.

In February, Sajid Javid, the health and social care secretary, set a target for 90% of NHS trusts to have introduced EPRs by the end of 2023, with the remaining 10% needing to be in the process of implementation. Miriam Deakin, director of policy and strategy at NHS Providers, said that it would be “challenging” for the NHS to meet the government’s target, however. She added: “Trust leaders know that it’s vital to get EPRs right but they are delivering this while overstretched staff are working flat out to tackle backlogs and deliver care to patients as quickly as they can.”

Rory Deighton, acute lead at NHS Confederation, said trusts’ efforts to roll out EPRs quickly and effectively have often been “hampered by inadequate levels of available capital funding”.

NHS England is pushing for ICSs to reduce the number of EPRs within an ICS to help data move more easily between organisations, and saving clinicians from having to spend time familiarising themselves with different EPR systems.

HSJ asked every NHS trust in England if they have an EPR, and, if not, whether they were currently procuring an EPR. Although 27 trusts responded that they did not have an EPR, the publication reported that NHS England believes that there are 35-40 trusts without adequate EPRs.

Among the 27 trusts are a number of major teaching hospitals, including Liverpool University Hospitals Foundation Trust (LUFHT), Nottingham University Hospitals Trust (NUHT), and Norfolk and Norwich University Hospitals Foundation Trust (NNUH).

Many trusts are planning joint procurements

LUHFT told HSJ it was in the process of procuring an EPR as part of a national programme launched last year to improve EPR procurement. NUHT said it was using “elements” of one EPR and had “plans to purchase the remaining elements in the next two years”, while NNUH is working on a joint EPR procurement with Queen Elizabeth Hospitals King’s Lynn and James Paget University Hospitals Foundation Trusts.

All the trusts that responded to HSJ’s questions said they were either in the process of procuring one, or developing a business case to secure funding in order to launch a procurement.

Several trusts said they planned to run joint procurements for EPRs or align themselves with other trusts in their ICSs. These included University Hospitals Plymouth Trust and Stockport Foundation Trust. Mid Cheshire Hospitals FT and East Cheshire Trust said they had run a joint electronic patient record procurement and had chosen Meditech as their preferred provider.

FCC Insight

A move to electronic patient records is essential to improve both efficiency and safety in the NHS. It’s worrying that so many large teaching hospitals are still without adequate EPRs. Miriam Deakin of NHS Providers is correct, however, to say that it is not easy to carry out a major software implementation when overstretched staff are dealing with Covid backlogs. A report last week that NHS England intends to prioritise future investment funding to trusts without EPRs is welcome – and it’s now a matter of urgency that the remaining trusts receive as much support as possible in pushing forward with their implementations.