Northern Care Alliance (NCA) NHS Foundation Trust is working towards a new EPR and a centralised EDMS, as well as focusing on digital for pathway redesign.
“The creation of NCA has merged two separate trusts with differing digital capabilities, maturity levels and digital infrastructure,” the trust states. “This combined with legacy clinical systems and poor data quality has led to operational inefficiencies.” Work on a single EPR, along with a “resilient” digital strategy, aims to help rationalise and streamline digital systems and core infrastructure to drive efficiency improvements, it continues.
NCA reports being “hindered by its low level of digital maturity”, with the lack of a common EPR specifically pinned as a factor. This will be resolved in the coming years, working with frontline clinical staff to select and implement a new system, it promises. The lack of digital maturity is also said to be impacting on opportunities for the trust to take advantage of AI: “The full use and leveraging of artificial intelligence remains a distance away for the NCA given our need to stabilise our foundations, and yet we are already supporting programmes and initiatives that step us into the AI space.”
Progress on the single EPR has been “far slower than expected”, according to NCA, with changes to NHS England digital funding routes and NCA deficit making it challenging to progress beyond the outline business case. “Work to identify capital funding continues in support of the programme and an updated OBC is due to be presented to the board during this financial year,” it updates. “The team are working with community colleagues to set out a clear strategy for a community EPR which remains a gap in our strategic plans.”
A programme update from the senior responsible officer and programme director for the EPR programme highlights a “significant capital shortfall of £42 – 43 million”, with efforts ongoing to strengthen this through the outline business case, and contingency plans for capital reallocation in case national funding is not forthcoming. “Current timelines suggest a best-case go-live in 2029 through partner adoption, while a full procurement route may extend to 2030,” the board notes.
On work toward the EPR programme, the trust states that clinical leads are mapping application roadmaps, looking at opportunities to refresh or retire systems, and quantifying risks associated with different delivery timeframes.
Also of note is a single centralised EDMS for NCA, due to be delivered in 2027, designed to streamline processes, improve efficiency, and reduce costs associated with digital documentation. Activities to be completed in preparation include digital destruction to support data migration, and clinical documentation standardisation with enhanced governance.
In other areas, the trust notes that the scope has been completed for “right-sizing and remediating” its digital infrastructure (cloud first), with a cost model to track total cost of ownership across NCA digital services. In referral to treatment, the trust highlights digital validation initiatives, including chatbot engagement with 20,000 patients , “which resulted in 1,700 deflections and improved capacity for new or urgent follow-ups”.
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