The board of Barking, Havering and Redbridge University Hospitals NHS Trust in its latest meeting discussed some of the initial outcomes, challenges, benefits, and opportunities from its newly launched EPR.
The EPR went live in November 2025 alongside EPMA, at a cost of £50 million. The trust’s radiology information system, picture archiving and communications system, and laboratory information management systems were upgraded simultaneously.
“Many people across the trust worked extremely hard to ensure the launch went as well as it did,” Barking, Havering and Redbridge shares. Support and involvement from Barts Health “has been a model for how providers can share knowledge and expertise to help improve patient care, safety and staff experience”, it adds.
A raft of other feedback is also offered by the board, which states that benefits from the system have been easier to deliver on wards, where time has been freed up for clinical staff to spend with patients; and harder to realise in theatres and outpatient clinics.
Those benefits have reportedly improved the ability to track patient flow and safety metrics, the trust notes, with work on organisational resilience, capturing lessons learned, and leadership support set to continue. Having patient data integrated into a single digital record is also expected to help streamline workflows.
Impact on performance was “anticipated” and factored into recovery plans, according to Barking, Havering and Redbridge, highlighting challenges remaining with radiology data migration and imaging, and outpatient appointments. “Of the 1518 incidences reported in November, 63 related to the introduction of these digital systems,” the trust says. “Almost a third of EPR-related incidents were reported under Medication categories with a combination of prescribing and administration issues. Monitoring and escalation of these incidents continues.”
Performance issues during EPR and PACS go-live led the board to identify an “urgent need” to upgrade Cisco network devices, specifically firewalls. This led to reported bottlenecks and an impact on elective services. A loan of two firewalls from Barts Health temporarily resolved this, and the trust is pursuing a holistic upgrade of data centre design and network architecture, to include professional services for redesign, capitalisation of assets, and renewal of network appliance licences at additional monthly revenue cost. Under this model, a managed service provider will take on responsibility for managing the network.
Ward-based EPR training has begun, with a focus on referrals, skin integrity, and wound documentation, the trust highlights, and an EPR audit has recently been completed with the aim of identifying system and user issues early. The Board Assurance Framework includes benefits realisation from the EPR under quality and safety, with deliverables covering the use of digital champions, the delivery of a 50 percent reduction in paper-based clinical documentation, real-time data availability, and strengthened information governance.
Summing up, Barking, Havering and Redbridge’s chief executive said: “Despite the predictable bumps along the way, it’s exciting to have entered a new digital era at BHRUT which will improve safety, reduce errors and transform the experience of working here.”
Wider trend: Post-EPR optimisation
The Royal Wolverhampton NHS Trust has shared updates on phase one go-live of its EPR programme and a revised EPR milestone plan to the end of 2026 and beyond. Phase one covered the replacement of the trust’s patient administration system for acute and community services, as well as the emergency department patient first system and theatre management system. Although most parts of the transition were delivered on time, Royal Wolverhampton notes that there was a delay due to the complexity of emergency department data.
East Suffolk and North Essex NHS Foundation Trust has reviewed its EPR programme, following the implementation of Epic in October 2025, highlighting positive outcomes, learnings, and early service impact. The chief executive noted that the experience of EPR implementation was positive, “the system did not fail, we have not returned to paper, and we reported in the first week post go-live”. On its approach to go-live, the trust shares that “intensive focus” was placed on application building and testing, wait list validation, work queues, clinic templates, activity stabilisation planning, data migration, cutover planning, and organisational readiness.
A roadmap for delivery of Birmingham Women’s and Children’s NHS Foundation Trust’s latest strategy to 2030 has outlined a series of digital priorities across the next four years, covering post-go-live EPR optimisation, piloting AI, cloud migration, and a device and infrastructure refresh. Investments continue to be made in estates and digital maturity, and progress is being seen in stabilising the digital environment following Epic go-live with strengthened oversight around digital delivery. Challenges remain, according to BWC, relating to reliance on legacy systems and post-Epic data quality and reporting issues, as well as capacity pressures with digital and informatics teams.
