‘No new suppliers’ promises ICS as four trusts eye EPR purchases

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Liverpool University Hospitals to make second attempt at EPR procurement
Three neighbouring trusts to launch separate joint process

A major acute provider will make a second attempt at procuring a new electronic patient record, while three neighbouring trusts are planning to launch a separate tender process, HSJ has learned.

All four trusts sit within the Cheshire and Merseyside Integrated Care System, which is among the least joined-up ICSs for electronic patient records despite a national push for convergence. Its chief executive has said the impending procurements should not “introduce any new EPR vendors” into the ICS’s “complex EPR landscape”.

Liverpool University Hospitals Foundation Trust has submitted an outline business case for a new EPR to NHS England, hoping it can soon gain approval to launch a procurement process.

The trust’s main hospitals abandoned a previous tender process in which US firm InterSystems was selected as their preferred provider in 2017. The reasons for this were unclear.

It is thought a new EPR could require around £70m in capital funds, although the existing in-house systems would also require significant investment if they had to be extended.

Despite having no existing EPR, some of the digital systems used at the Royal Liverpool Hospital are said to be relatively advanced. NHSE recognised the site as a “digital exemplar” in 2016. However, the infrastructure at Aintree, which merged with the Royal in 2019, is less advanced.

The LUH procurement will be complicated by the need to ensure compatibility with the specialist trusts in Liverpool, which run on various other EPRs, including Meditech and Altera.

Meanwhile, three neighbouring providers – St Helens and Knowsley Teaching Hospitals Trust, Southport and Ormskirk Hospital Trust, and Warrington and Halton Hospitals FT – are preparing to launch a separate joint EPR procurement.

STKH and SOH (due to be acquired by STHK) currently use System C, while WHH runs on the Lorenzo system.

Cheshire and Mersey Integrated Care Board chief executive Graham Urwin said the LUH procurement is “imminent”, adding: “Our strategic position is one where we won’t introduce any new EPR vendors into the C&M digital economy and will converge around fewer supplier solutions where patient flow and other organisational strategies align…

“Cheshire and Merseyside has a complex EPR landscape with a mix of vendors across the footprint and 17 trusts at very different stages of maturity.

“The case for converging to one supplier across the whole geography is not compelling where trusts are pursuing high levels of digital maturity… with established solutions and the geographical spread between some organisations means there is very little, if any movement of patients between them.

“Where we have a closer grouping of organisations with shared patient activity, we are working to align strategies around common EPR provision.”

He said the system is using a strategy where trusts undertaking EPR deployments and significant upgrades are sharing key implementation resources and will share key back office support resources in the long-term. A shared ICB deployment team is also being considered.

Research by HSJ last year found that, at that time, Cheshire and Merseyside’s 17 trusts used 10 different EPRs between them. In early 2022, NHSE asked ICSs to make plans for a single or converged EPR.