April brings a new financial year — and sharper scrutiny.

For NHS Boards and executive teams, digital investment must now demonstrate measurable frontline productivity, not just successful implementation.

The question is simple:

Where is digital improving care and flow — today?

**From digitisation to demonstrable value **

Moving from analogue to digital remains essential. But the conversation has shifted.

Does the EPR improve discharge timeliness?
Does it reduce unwarranted variation?
Does it release clinical time?

Productivity is not a reporting exercise. It is a leadership discipline — requiring benefit realisation, governance clarity and clinical ownership.

As Paul Charnley, former Director of IT at Wirral University Teaching Hospital NHS Foundation Trust, reflected during a major EPR journey:

**“Digital only delivers value when it is owned at every level of the organisation. Go-live is a milestone — but productivity comes from how effectively teams use and optimise the system every day.” **

That insight reframes the agenda.

Optimisation is where value is won

Go-live is visible. Optimisation is quieter — but more consequential.

In practice, it means:

• Aligning workflows to operational reality
• Reducing friction for frontline teams
• Using data to target improvement

It requires robust governance — Design Authorities, Change Boards and clinical safety oversight — not as bureaucracy, but as clarity. When trade-offs are transparent, confidence grows.

At Countess of Chester NHS Foundation Trust, the integration of e-RS direct booking into the Millennium EPR demonstrates how targeted optimisation can unlock immediate value. By digitising end-to-end referral pathways and embedding them directly within the clinical workflow, the Trust has reduced reliance on manual processes, improved access to referral information at the point of care, and enabled faster, more coordinated clinical decision-making — strengthening both productivity and patient experience.

But optimisation also depends on capability.

Sustainable productivity requires sustainable capability

Many Trusts continue to rely heavily on contractor resource to configure and evolve their EPR systems. While often necessary during implementation, long-term dependency can increase costs and limit organisational ownership.

If productivity is the goal, internal capability becomes infrastructure — not overhead.

For some organisations, the question has become: how do we build capability that stays?

One example is the FirstLight programme, developed with University Hospitals of Leicester NHS Trust. Rather than relying indefinitely on external markets, the Trust invested in growing its own configuration, testing and reporting specialists through a structured apprenticeship pathway. The programme saw 80% of graduates move into NHS roles, saving around £1.05M annually by reducing contractor reliance.

“Productivity thrives when digital expertise is grown, not borrowed. In-house EPR teams—like apprenticeships—don’t just sustain systems; they sustain confidence, ownership, and lasting impact” _Andy Carruthers, Group CTIO at University of Leicester NHS Trust & University Hospitals North Hamptonshire
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The relevance is not the programme itself, but the principle: when optimisation expertise sits within the organisation, change cycles shorten, knowledge compounds and productivity gains are more likely to sustain.

In a productivity-driven environment, capability becomes part of governance — not simply workforce planning.

Innovation without disruption: the power of partnership

Optimisation is not only about refining what is already deployed. It is also about enabling innovation without destabilising core systems.

In one recent NHS collaboration, tailored workflows were integrated into an Oracle EPR using API technology — allowing best-of-breed functionality to sit alongside existing platforms rather than replace them.

The insight is structural: best-of-breed innovation succeeds when integration is aligned to governance, workflow reality and cost control.

When global technology expertise is combined with experienced EPR oversight, Trusts gain:

• Governance-aligned integration
• Workflows grounded in frontline practice
• Innovation that enhances flow rather than creates friction

In a productivity-focused NHS, innovation must strengthen operational confidence — not introduce additional risk.

Board leadership remains the enabler

Technology, workforce and partnerships all matter. But without visible leadership, benefits rarely sustain.

Organisations that accelerate optimisation share common traits:

• Executive sponsorship
• Clear benefit tracking linked to operational metrics
• Embedded clinical ownership
• Transparent governance

Where these conditions are present, digital becomes operational confidence — not digital fatigue.

April is an opportunity

A new financial year is not only about constraint. It is about clarity.

Are digital investments clearly linked to frontline productivity?
Do we have the capability and partnerships to sustain optimisation?

Digital maturity is no longer measured by implementation alone. It is measured by operational confidence.

Productivity is not a finance agenda. It is a patient agenda.

And in the year ahead, that distinction will matter more than ever.

Sources & Further Reading (UK)

NHS England, Digital transformation: https://www.england.nhs.uk/digitaltechnology/
NHS Confederation – Financial sustainability and system prioritisation:
https://www.nhsconfed.org/