Editorial

NHS trusts still reliant on paper

Despite a push to digital systems, most NHS trusts are still dependent on paper notes.

Posted 19 September 2023 by Christine Horton


Most NHS trusts in England are still reliant on paper patient notes and drug charts, despite progress towards electronic records and prescribing.

Of the 182 trusts that responded to a BMJ survey published last week, four percent (seven trusts) said that they only use paper notes, while 25 percent (45 trusts) were fully electronic, and the remaining 71 percent (130 trusts) use both paper and an electronic patient records (EPR) system.

The survey results have coincided with a House of Commons committee that concluded that the UK government had failed to meet a key target to eliminate paper prescribing in hospitals and to introduce digital or electronic prescribing across the entire NHS by 2024.

The BMJ notes that under the NHS Long Term Plan, trusts are being challenged to achieve “a core level of digitisation by 2024” and to “accelerate the rollout of EPR systems and apps.”

The current targets are that 90 percent of NHS trusts should have an EPR system by the end of 2023, and 95 percent by March 2025. In England, the NHS says that it is investing nearly £2 billion to encourage trusts to adopt EPRs; £440 million was spent last year to help hospitals install or upgrade, according to NHS England. NHS figures from May this year show that 88 percent of trusts in England now have EPRs.

Low confidence in delivery of EPRs

However, a report published earlier this year by the government’s Infrastructure and Projects Authority downgraded its assessment of how likely the NHS is to hit its deadline for the rollout of EPRs.

“Delivery confidence is red [the lowest rating] as a number of NHS trusts are reporting they are unlikely to be able to fully implement an Electronic Patient Record by March 2025,” said the report.

It forecasts a new end date of 2026 for the project.