East Midlands Ambulance Service NHS Trust has signed a contract with provider Terrafix to replace its current electronic patient record system, with the new platform due to be implemented over the next year.

The move follows the trust's decision to review the market ahead of the expiry of its existing EPR contract, which is due to end in 2027. According to the trust, this presented an opportunity to identify a modern platform capable of supporting future clinical practice, improving interoperability and enabling further service improvement.

The trust has set out several objectives for the new system. These include reducing duplication in patient records, improving the quality of data capture, and incorporating digital clinical decision support tools intended to assist staff during patient care. A further priority is improving handovers, ensuring that all relevant information is readily available to those involved in a patient's treatment as they move between services.

A group of EPR "super users," drawn from frontline staff, has been involved throughout the procurement process, and the trust said this group will continue to work alongside Terrafix during system design. Training and ongoing support will be made available to EMAS staff as implementation proceeds.

Steve Bowyer, EMAS chief digital officer, said the new platform would help support frontline teams by providing up to date information and by improving the handover experience for both EMAS staff and hospital colleagues. Derek Neve, EPR digital service owner at EMAS, said the trust's aim was to deliver the best possible solution for everyone who uses or interacts with the EPR system, adding that this extended beyond frontline users to hospitals, healthcare providers and other partners who may rely on elements of the system.

The contract sits within a broader strategic context for the trust. Earlier this year, EMAS published its Strategic Estates Plan to 2035, which sets out a future state vision built around a strategic hub model enabled by technology. The plan stated that the trust's current estate was constructed for an ambulance service model that no longer reflects the scale, complexity or operational needs of today's service, and that a structured, prioritised programme was needed to secure an estate fit for future emergency care.

EMAS's announcement comes as similar EPR programmes progress at varying stages across the NHS, with mixed results. Norfolk and Suffolk NHS Foundation Trust has moved to what it describes as full mobilisation of its own EPR programme, following confirmation from NHS England. The trust's board has submitted a full business case for its SystmOne system, and six Listening into Action teams have been assembled to guide the design and configuration work required to tailor the platform to the trust's needs. Staff training is under way, along with the migration of data from the trust's previous Lorenzo system, with a go live date targeted for 2027.

North West Ambulance Service is preparing for its own procurement, having issued a market notice ahead of a planned tender in February 2027 for a unified command and control and EPR platform, with an estimated total value of £19.3 million. The trust has indicated that requirements for the new system will focus on minimising duplication, improving clinical safety and ensuring real time information flow between control room operations and frontline care settings.

Not all EPR programmes are proceeding smoothly, however. Norfolk and Waveney University Hospitals Group has forecast an £11.4 million overspend on its EPR programme, split between Norfolk and Norwich University Hospitals Trust, at £10.2 million, and James Paget University Hospitals Trust, at £1.2 million, against original budget plans. An EPR programme review is currently under way, with the group indicating that its findings could have significant implications for spending in both 2026/27 and 2027/28. An update from that review is expected in the second quarter, with the trust's board warning that failure to secure additional funding could lead to cash pressures, a breach of its capital departmental expenditure limit, or even a failure to complete the programme altogether.

Taken together, these developments illustrate the uneven progress being made on electronic patient record systems across the NHS, with some trusts advancing steadily towards implementation while others face significant financial and operational strain in delivering similar upgrades.

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