Lincolnshire Community and Hospitals NHS Group has outlined a three-phase plan to replace its paper-based patient records with a new electronic system, with the first two phases due by April 2027. The board has described the programme as currently in a critical phase and has signalled that clinical and operational teams will need to maintain close engagement for it to stay on track.
The rollout is structured around three sequential stages of increasing complexity. Phase one, scheduled for October 2026, covers front-door systems, patient safety tools, bed and flow management, and diagnostic investigations. Phase two follows in April 2027, subject to confirmation from the system supplier Nervecentre, and includes electronic prescribing, inpatient paperless records, and infection prevention and control functions. Phase three has no confirmed delivery date. It involves integrations with theatre systems, outpatient clinical records, a patient services hub, and interfaces with external systems, and the board has acknowledged it is the most technically demanding part of the programme.
Scheduling decisions have already been shaped by operational realities. Certain components have been moved to avoid clashes with urgent and emergency care activity during peak winter periods, a pragmatic adjustment but one that reflects the difficulty of running a major technology programme alongside day-to-day clinical demand. The board notes that further workflows still need to be designed and that gaps in the organisational development model are being urgently addressed. From this month, oversight of the programme is set to increase.
The financial picture carries risk. The trust's finance and performance committee has raised concerns about the potential for spending to exceed what was projected in the original business case, and a review of delivery objectives, timescales, and resource requirements is underway. The committee has not specified by how much costs could overshoot, but the fact that a review is in progress at this stage of delivery suggests the original estimates are under pressure.
Separately, a cyber compliance report from August 2025 identified risks linked to unsupported and legacy systems across the group. The board noted that the new electronic patient record system and a parallel electronic document management programme would reduce the number of those systems in operation, framing the digital transition partly as a risk-reduction exercise. Legacy infrastructure is a longstanding vulnerability across NHS organisations, and Lincolnshire is not unusual in treating its EPR programme as an opportunity to retire outdated technology alongside the primary goal of improving clinical records.
Progress on the wider digital agenda has been mixed. Virtual consultation services and the document management programme are reducing the volume of physical records and supporting remote care, and the board has reported good overall progress on its digital work streams. It has also acknowledged slippage on some agreed timescales, a candid admission that the programme is not running entirely to plan even before the more complex third phase begins.
Lincolnshire's trajectory sits within a broader pattern of NHS digital investment. Lewisham and Greenwich NHS Trust recently signed a ten-year contract worth £52 million with the American electronic health record company Epic, having operated for years with a partially deployed system that left around a fifth of its clinical applications unintegrated. East Sussex Healthcare NHS Trust completed the first go-live of its own programme earlier this year, moving its patient flow tracking system to a cloud-based platform, with a larger deployment scheduled for September 2026.
The common thread across these programmes is that they are technically ambitious, financially exposed, and operationally disruptive during delivery. Lincolnshire's board appears aware of those pressures. The combination of a phased structure, an open acknowledgement of cost risk, and the scale of what phase three will require suggests the organisation is being realistic about what lies ahead. Whether the programme holds to its current timeline will depend significantly on whether the resource review now underway produces an honest account of what delivery actually requires.
