Dr Jonathan Bloor, Medical Director, System C.

As the NHS has a further push to get all Acute NHS Trusts to a minimum level of digital maturity, many people are rightly asking why aren’t we already there, how long will it take, how much will it cost and why will things be different this time?

The KLAS 2023 survey found 66% of variation in usability with an EPR was down to the organisation and not the software. This was backed up by NHS England’s EPR usability survey, which shared multiple examples of variation between different organisations with the same EPR. This points to the fact that reaching digital maturity in healthcare is as much about people, process and cultural change as it is about choice of EPR supplier. This has come into stark focus over the last two weeks with the HSJ and BBC publishing articles highlighting NHS organisations that are having significant safety, operational and reporting challenges years after their EPR go-lives with some tragic events resulting in loss of life.

With NHS finances in perhaps the worst position they have ever been in, can the NHS afford significant variation in the cost of EPR procurements, given the lack of evidence of value for money and the major issues that many NHS Trusts are now facing post deployment?  For many organisations, would it be better to build on investments already made, deliver value quicker and not run the risk of major safety, operational and reporting issues?

Over 40 years our deployment and transformation approach has evolved to reflect the evolving NHS and technology landscape and is crucially modified to the needs of each organisation we work with. We have supported some of the organisations with the highest profile challenges and we have learnt that what and how you do it is really important. 

5 key learnings

Invest In the Right People

Digital maturity can be accelerated with the right investment in people, with a focus on co-creating new ways of working with frontline staff and the right Executive sponsorship. This was proven during Covid, but it has to be sustained as go-live is only the starting point.

All Workflows Are Addressed Together

Ensure administrative, operational and clinical workflows are all addressed together and not any at the expense of each other. We are already seeing the consequences of not doing this. One simply won’t work without the others.

Flexibility & Adaption are Crucial

Flexibility and adaptation is crucial as NHS organisations and their workflows are different. Making big bets on current organisational structures is likely to store up trouble for the future when those organisational structures will inevitably change.

Don't Make Decisions on The Promise Of Single Systems

Although alluring, don't make decisions on the promise of single systems that will service primary care, community, mental health, acute care and social care. There are reasons why they don’t already and never will exist.

Focus On What Matters

Focus on what matters, which are the things that are going to improve outcomes for patients and deliver value for money. That means focussing on health and social care integration and population health, which for many can be achieved by building on the investments already made.

Experience and organisational memory are really important.  We saw how to accelerate digital maturity during Covid. We should be doing more of the same rather than perhaps doing things that we know have failed in the past.