Progress towards widespread adoption of EPRs has been slow, but our survey suggests that staff think benefits are beginning to emerge. Most NHS staff now use an EPR system and feel these systems are already saving time and offering benefits to patient safety and care.  

However, the overall picture is complex, and a range of challenges remain. More than a third of staff say EPRs are not currently working well in their organisation, and many face barriers such as navigating multiple systems, insufficient training and limited support when problems arise. These challenges risk limiting the potential gains from the substantial investment that has been made into EPR systems to date. The next phase of EPR policy must tackle them head on. 

Create a national roadmap for improving EPR use

The results of this survey reinforce the need for a national roadmap focused on improving how EPR systems are used across the NHS. While national policy has rightly prioritised ensuring that all NHS trusts have an EPR system, significant work remains to ensure that the value of these systems is maximised. 

Despite the challenges identified, staff attitudes towards the future of EPRs remain strikingly optimistic – the vast majority believe EPRs are either already delivering benefits or will do so in the future. A national roadmap should build on this underlying confidence, supporting organisations to move beyond basic digital record keeping towards more advanced uses, including clinical decision support, quality improvement and population health management. This will require coordinated action across national bodies, system leaders, health care providers and EPR suppliers to improve usability, support staff engagement and ensure EPR systems are successfully embedded into everyday practice.

Coordinate action to overcome fragmentation 

The Department of Health and Social Care and NHS England should coordinate action across providers to improve the effective use of EPRs throughout the NHS. Priority should be given to addressing interoperability challenges, enabling information to flow safely and efficiently between NHS organisations and preparing the ground for initiatives such as the single patient record. Given that the most reported barrier to more effective use of EPRs was differences between EPR systems making it harder to work across organisational boundaries, action on this is urgent. This should include strengthening adherence to information standards and investing in enabling infrastructure. 

The Data (Use and Access) Act 2025 and the forthcoming NHS reform legislation present key opportunities for government to accelerate progress on interoperability, clarifying enforcement arrangements for information standards and ensuring relevant patient data can be shared effectively across the health system.

Provide more training and support for staff to use EPRs effectively

It is striking that over half of respondents reported not having received training on ‘the basics’ or how to use the EPR system for their specific role. Increasing the number of staff who have access to these two types of training will be essential if the NHS is to reap further benefits from EPR systems. 

As explored in our previous qualitative research, staff need to be trained on the tasks involved in basic, day-to-day uses of EPRs – such as how to use shortcuts and correctly code medical conditions – as well as why to do these things and the positive impact they have on the system. This would help give them ownership and awareness of the benefits these systems can bring. Only then can more advanced functionalities – such as quality improvement tools or decision-support features – be meaningfully introduced. When implemented well, these more complex functionalities can offer benefits to productivity, safety and quality of care. 

Several of the other barriers to more effective EPR use that our survey identified could be addressed through ensuring staff have better access to real-time support and that EPRs are better integrated into workflows. On the latter, respondents reported that EPR systems have added new tasks or made some tasks take longer. Improving the use of these systems will require greater attention to the design and implementation of new ways of working, ensuring EPRs reduce rather than add to the administrative burden.

Staff engagement is a critical factor in unlocking value from EPRs. While overall NHS staff perceptions of EPRs are positive, our survey suggests that issues around usability, training and support may be limiting the benefits these systems can deliver. Staff experience should be treated as a core performance metric for EPR optimisation and used to guide prioritisation of investment and improvement efforts.