Ensuring continuity of EPR service provision

Matt Donnelly discusses the procurement of EPR systems and the importance of a framework that is targeted to the digital needs of the NHS

Published on HSJ News 20 January 2021

The increased uptake of Electronic Patient Record systems shows clear evidence of the digital transformation currently ongoing throughout the NHS and how the NHS can access new technologies to improve healthcare and innovate ways of working.

While the concept of an EPR System is not a new idea, suppliers innovate and advance their offerings regularly and new suppliers are bringing increased competition to market. The gradual transformation from physical patient records to digital “on premises” solutions to newer cloud-hosted EPR systems has allowed organisations to access new, innovative technologies in an often more cost-effective and straightforward manner.

Contracts for EPRs are commonly for a fixed duration and on a recent HSJ webinar by Nicholas Carding on EPRs, HSJ Intelligence suggested that over 80 EPR contracts at NHS trusts are to expire in the next five years.

Plans for a replacement or updated EPR system will often start over a year in advance of expiry, as considerations around the procurement process and issues like the migration of patient data between suppliers must be considered. It is essential to ensure that there is continuity of EPR service provision.

There are several potential mechanisms available to NHS organisations to contract with suppliers, but arguably the main and preferred way will be to call-off from a suitable framework.

Although using a particular framework is not mandated, Hempsons worked with NHS England and NHSX to introduce a new “Lot 1” to their Health Systems Support Framework in August 2019, which was designed to allow trusts and other NHS organisations to digitise more quickly to interoperable standards.

This new “Lot 1” appointed eight EPR suppliers to the HSSF, assured to deliver robust EPR systems following extensive evaluation by evaluators from a number of organisations such as NHSE/I, NHSX, NHS Digital and local systems. This Lot and other services available under the HSSF such as shared or integrated care records and transformational services at a system level provide a comprehensive route to access pre-accredited suppliers.

When a supplier and their EPR System has been selected by a trust under a framework, the call-off contract will need to be finalised and signed. This call-off contract should mirror the contract used in the procurement process. However, suppliers often look to negotiate terms at this stage. NHS organisations need to be very careful to ensure that any changes agreed post award do not constitute a material variation of the contract tendered for the purposes of procurement law.

Hempsons have assisted NHS foundation trusts and NHS trusts both individually and collaboratively in their procurement and contract negotiation for new EPR systems under a number of different frameworks. Whilst there are several routes to access the supplier market, our work with NHSE England and NHSX on the evolving development of the HSSF family of frameworks has emphasised the importance of a framework (such as the HSSF) that is targeted to the digital needs of the NHS, and that bakes in the required interoperability standards to enable cross system roll-outs.