NHS must move EPR use beyond digitising paper, report warns
The NHS is at risk of missing the full benefits of electronic patient records (EPRs) without a national strategy to move them beyond ‘digitising paper’, new analysis from The Health Foundation warns.
The report, ‘Electronic patient records: Why the NHS urgently needs a strategy to reap the benefits‘, published on 9 April 2025, found that while 90% of NHS trusts now have an EPR system in place, many are not using them to meaningfully improve care quality, staff experience or productivity.
Instead, a number of trusts are treating EPR systems as “essentially digital notebooks,” leaving more advanced capabilities that can meaningfully improve clinical decision-making and system performance – such as AI – out of reach.
The report says: “Simply ‘digitising paper’ doesn’t change the way we deliver care.
“NHS organisations need to be able to deploy EPR systems effectively to reap their benefits.
“The NHS urgently needs a route map that sets out first, what trusts must do to ensure their EPR’s basic functionalities are being used as intended, and second, how to go beyond this to reap the ever-growing list of potential benefits that such systems can offer.”
The Health Foundation interviewed five NHS acute trusts to understand how EPRs are being used and what barriers are holding back progress.
It found that there were inconsistent data entry practices, with many clinicians entering information as free text or PDF documents, which makes it difficult to extract reliable data that could be used for service planning or improvement, or more advanced capabilities involving AI.
The report also found that many staff don’t receive adequate support to use EPRs effectively beyond the most basic functions, resulting in low engagement and limited use of available tools.
“Training in ‘why’ to do things, not just ‘how’ to do things, can help give staff more ownership and awareness of the benefits that EPRs can bring when used in the right way, both for individual patient care but also for the wider system,” it says.
For the NHS to reach a level of digital maturity similar to NYU Langone Health, one of the most digitally advanced hospital systems in the US, the report said it would require sustained investment over a 15-year period.
One of the paper’s research authors, Alex Lawrence, improvement fellow at the Health Foundation, told Digital Health News: “Now that nearly every trust in England has an EPR system, the government and NHS leaders must set out a new strategy to enable staff and patients to make the most of them.
“This national roadmap should be supported by plans developed by each trust.
“To reap the benefits of EPRs, we’ll need to fund the change, not just the tech.
“That won’t be easy in today’s financial context, but the prize will be improved ways of working for staff, more efficient services and better outcomes for patients.”
In November 2024, Malte Gerhold, director of innovation and improvement at The Health Foundation, told Digital Health News that the government needs to do more to support NHS staff in implementing technology.
