Only around 30% of NHS trusts with electronic patient record (EPR) systems have achieved fully integrated data flows, according to new findings from the Digital Maturity Assessment (DMA). The results highlight a significant gap between the adoption of digital systems and their effective use, raising concerns that the NHS is not yet realising the full benefits of its substantial investment in digital infrastructure.
While the majority of trusts now have EPR systems in place, a key milestone in NHS digital transformation where many continue to operate with fragmented data architectures. This limits the ability of clinicians to access complete patient information in real time and hampers coordination across care settings. Experts warn that without better integration, the NHS risks replicating analogue inefficiencies in a digital environment.
Interoperability remains a major barrier
The DMA findings point to interoperability as one of the most persistent challenges facing the NHS. In many trusts, EPR systems are not fully integrated with other clinical and administrative platforms, such as pathology systems, imaging databases or primary care records.
This fragmentation can result in duplicated data entry, delays in information sharing and increased administrative burden for staff. Clinicians often need to navigate multiple systems to build a complete picture of a patient’s history, which can affect both efficiency and clinical decision-making.
The issue is particularly acute when patients move between different parts of the health system, such as from hospital to community care, where seamless data exchange is critical. Despite national efforts to promote interoperability standards, progress has been uneven, with variation in digital maturity across regions and organisations.
Streeting emphasises need for connected systems
Health Secretary Wes Streeting has acknowledged the challenges highlighted by the DMA, stressing that digital transformation must go beyond system implementation. In an official statement on NHS technology, Streeting said: “It’s not enough to have digital systems in place, they must work together to support better care for patients.”
He also underlined the importance of integration, adding: “We need a truly connected NHS, where information flows seamlessly across services and supports clinicians to make the best decisions.” Streeting has made interoperability a key priority within the government’s wider NHS reform agenda, linking it to improvements in productivity, patient safety and experience.
Impact on patient care and system efficiency
The lack of integrated data flows has direct implications for both patients and staff. For patients, fragmented systems can lead to delays in diagnosis and treatment, as well as the need to repeat information or undergo duplicate tests. For staff, the administrative burden associated with navigating multiple systems contributes to inefficiency and can detract from time spent on patient care.
Health economists have also pointed to the financial impact, noting that poor interoperability can lead to wasted resources and missed opportunities for more efficient service delivery. In the context of rising demand and constrained budgets, improving data integration is seen as a critical lever for enhancing productivity across the NHS.
Technology and vendor challenges
Part of the challenge lies in the complexity of the NHS digital ecosystem, which includes a wide range of legacy systems, vendor platforms and locally developed solutions. Integrating these systems requires not only technical solutions but also alignment of standards, governance and procurement processes.
Vendors are increasingly being asked to demonstrate interoperability as a core feature of their products, but achieving seamless integration across diverse systems remains difficult. There are also concerns about vendor lock-in, where reliance on specific platforms can limit flexibility and hinder data sharing. To address these issues, NHS England has been promoting open standards and encouraging collaboration between suppliers.
The role of data in future NHS transformation
Improving data integration is central to the NHS’s broader ambitions for transformation. Advanced analytics, artificial intelligence and population health management all depend on access to high-quality, integrated data.
Without this foundation, the potential of these technologies cannot be fully realised. For example, predictive analytics tools require comprehensive datasets to identify trends and support proactive care, while AI applications depend on consistent and interoperable data inputs. The DMA findings suggest that while progress has been made in digitisation, the next phase of transformation must focus on connectivity and data quality.
Bridging the gap between adoption and impact
The gap between EPR adoption and effective data integration represents a critical challenge for the NHS. While achieving widespread implementation of EPR systems is a significant milestone, it is only the first step towards a truly digital health system.
Bridging this gap will require sustained investment, strong leadership and a clear focus on interoperability as a core objective. It will also involve cultural change, with organisations needing to prioritise data sharing and collaboration across traditional boundaries.
For policymakers and health technology leaders, the message from the DMA is clear: digital transformation is not just about installing systems, but about ensuring they work together to deliver tangible improvements in care. As the NHS continues its journey towards a more integrated and data-driven future, addressing these challenges will be essential to unlocking the full value of digital innovation.
