94% of NHS acute trusts have an EPR in place, finds report

A snapshot report on the acute electronic patient record (EPR) market has found that 94% of NHS acute trusts in England have an EPR in place.

The report from Future Health Intelligence (FHI), focuses on contract wins and migrations between January 2024 and March 2025.

It highlights that the drive for acute provider digitisation in the NHS gained pace in 2024, with EPRs continuing to be “the cornerstone of this digital transformation”.

Last year’s report showed that 19 acute trusts (13%) out of 134 in England were without a live EPR, however just eight trusts (6%) now lack one.

The government’s £2bn Frontline Digitisation programme is pushing for full EPR adoption across both acute and mental health trusts, with the deadline being extended by 12 months from March 2025 to March 2026.

FHI forecasts 97% EPR coverage (130 of 134 acute trusts) by March 2026, with the remaining trusts well advanced in their implementation plans.

Of the eight trusts without a live EPR, one has announced a preferred supplier, and three are in pre-market engagement or seeking approval to procure an EPR, the report states. The remaining four have not publicly disclosed their plans.

The report also looks at the EPR market share and which suppliers have secured the most contracts.

Oracle Health remains the EPR market leader, increasing its NHS EPR market share to 25%, an increase of 1.4% from the year before.

System C retains second position despite a 1.4% fall in its market share, while Epic saw the biggest gain, rising by 3.5% to 9.7%.

Alcidion, Altera, Meditech and Nervecentre each gained 0.7% while Dedalus saw a marginal decline of 0.7%, the report also shows.

Data from FHI illustrates that c.27% of the 134 existing acute contracts are due to expire within the next 12 months, with a further 8.5% up for renewal in the next three years.

While c.24% of trusts either lack an EPR or are out of contract, many of those out of contract are already implementing of procuring new systems, the snapshot report states.

One of the key takeaways of the report are that despite the encouraging progress in NHS EPR adoption, challenges remain.

Go-live delays for Oracle Health at Airedale NHS Foundation Trust and Sheffield Teaching Hospitals NHS Foundation Trust “reflect the complexity of implementation”, the report says.

“Meanwhile, some trusts are still not actively procuring, highlighting ongoing hurdles in achieving full EPR coverage,” it concludes.