ICSs asked to ‘converge’ their electronic patient record systems

ICSs were told earlier this month that they had until the end of last week to submit details about their trusts’ current use of EPRs, their plan for moving to a single EPR or make existing EPRs more interoperable, and how this would be funded.

The instruction came from NHSE’s transformation director Tim Ferris shortly before health and social care secretary Sajid Javid announced at the HSJ Digital Transformation Summit on Thursday a new target to accelerate the implementation of EPRs in the NHS.

Multiple sources said the demand prompted some “pushback” from digital leaders in ICSs and trusts, particularly around EPR convergence, which represents a costly challenge in many areas, requiring significant planning.

Mr Javid set a new target for 90 per cent of trusts to have installed an EPR by December 2023 and the remaining 10 per cent to be in the implementation phase by that point.

HSJ understands trusts’ chief information officers were told via regional heads of digital to complete a raft of information with only a few weeks’ notice amid a push from NHSE on speeding up EPR usage across the country.

However, very few ICSs comprise trusts which all use the same EPR, and many ICSs have trusts which use a lot of different patient record systems across their hospitals.

In April last year, North West London ICS became one of the first ICSs to commit all its four acute providers to the same EPR (Cerner).

But HSJ understands NHSE is keen for ICSs to move towards its providers having a single system, or – where this is not possible due to funding or capability – EPR convergence in which providers reduce the number of different EPRs in their ICS to improve interoperability.

While a single EPR can be difficult due to providers’ existing contractual arrangements and cost, convergence also presents challenges due to the hugely varied systems currently used by trusts.

ICSs were also told to supply details for how their planned EPR transformation would be funded. HSJ understands NHSE is already planning to tailor funding packages for the remaining trusts without an EPR, instead of the current 50/50 matched funding system.

The national commissioner is also looking at ways to make both the business case and EPR procurement processes faster amid complaints from trust CEOs that this can take more than two years.

NHSE is exploring ways in which national procurement support can be given to trusts and ICSs, and last year it launched – via NHSX – a pilot programme involving seven trusts whose purchasing of an EPR would be more centrally led.