Every NHS hospital trust now has an EPR installed, contracted or being procured, marking near-universal coverage across England.
New data shows that, for the first time, all NHS hospital trusts have installed, contracted for or started procuring an electronic patient record system.
The findings are contained in Future Health Intelligence’s 2026 English NHS Acute EPR Annual Contract Wins and Migrations report.
The milestone marks a key stage in the long-term digitisation of the NHS.
It also supports the shift towards digitisation, one of three changes outlined in the Government’s 2025 10-Year Health Plan, Fit for the Future, published in June 2025.
Electronic patient record systems, known as EPRs, are the core digital platforms hospitals use to manage patient care.
They support admissions, discharges and transfers, medical notes, medicine prescribing, laboratory test orders and requests for diagnostic imaging.
The report found that adoption accelerated over the past three years.
In 2022, then health secretary Sajid Javid set a target for 90 per cent of hospitals to have an EPR by March 2024, backed by £3.4bn of national investment.
Jon Hoeksma, CEO of Future Health Intelligence
The funding helped drive increased procurement activity across the health service.
Future Health Intelligence data shows that 19 hospital trusts had neither installed an EPR nor started procuring one in 2024.
That number fell to eight in 2025 and reached zero by March 2026.
Jon Hoeksma, chief executive of Future Health Intelligence, said: “The FHI EPR Annual Hospital EPR Report provides the most accurate data available on the state of the NHS EPR market, which remains the largest software segment in the £6bn NHS IT market.
“Finally reaching near 100 per cent coverage is a real achievement that deserves to be recognised and celebrated.”
US supplier Epic and UK company Nervecentre secured the largest numbers of EPR procurements over the past three years.
Almost all EPR suppliers in the market also secured new contracts during the period, which Future Health Intelligence said indicated a healthy market.
Hoeksma said: “With the Government once again interested in data sovereignty and supporting the development of British companies, it is really encouraging to see the fastest growing EPR provider is British success story Nervecentre, who continued to win key contracts over the year, with five new trusts contracts including Liverpool.”
The largest EPR contract awarded over the past year involved four trusts across Somerset and Dorset.
They awarded a £222m contract to Epic for a shared system.
The full report and Future Health Intelligence platform, which provides census-level data on NHS IT investments, contracts and contacts, are available exclusively to its clients.
Introducing EPRs across all NHS hospitals has been a national policy objective for almost three decades.
The goal was first set out in the 1998 Information for Health strategy, but delivering the systems proved more difficult than expected.
Hospitals have complex clinical and operational requirements, while installation programmes can cost hundreds of millions of pounds.
The EPR programme at Manchester NHS FT alone cost £500m.
National policy has also changed direction several times.
Frustration with slow progress following the 1998 strategy helped prompt the creation of the NHS National Programme for IT in the early 2000s.
The programme attempted to procure EPR systems nationally on behalf of hospitals.
Although it delivered useful national digital infrastructure, its centralised approach to EPRs failed and set the market back in some parts of England.
Trusts were given greater local autonomy during the 2010s, with some notable successes under the Global Digital Exemplar programme.
Since 2022, national policy has increasingly encouraged trusts to converge around a smaller number of EPR systems.
NHS England has indicated that the next phase of digital development will focus less on acquiring systems and more on using them to improve patient safety and productivity.
Hoeksma said: “Under NHS England’s Frontline Productivity programme the focus is shifting to how to drive benefits from the installed EPR systems, many of which are not being used to full effect yet.
“But the English NHS market still has strong momentum as older legacy systems come up for replacement, or as trusts merge or integrate with neighbours.”
A further wave of disruption is beginning to affect the EPR market as artificial intelligence tools become more widely used.
Ambient voice technology can listen during clinical consultations and automatically produce draft clinical notes, reducing the amount of documentation clinicians must complete manually.
Start-ups including Heidi, Lyrebird and Tortus are developing these tools.
Their emergence raises questions about whether specialist AI providers could bypass established EPR platform companies by supplying some services directly.
