• Although England is on the verge of every NHS trust having an electronic patient record (EPR) system, a small number of organisations are still struggling to reach this milestone, and many more aren’t yet using these systems to their full potential.
• Used well, EPRs can deliver important improvements to care quality and productivity, ensuring staff have access to health information and supporting them to deliver safe and effective care.
• To explore the challenges in realising the benefits of EPRs, we conducted interviews with leaders in five acute NHS trusts in England, and also looked at an example from a leading US medical centre. This piece presents insights from these interviews and recommends next steps for unlocking the potential of EPRs.
• Simply ‘digitising paper’ doesn’t change the way we deliver care. NHS organisations need to be able to deploy EPR systems effectively to reap their benefits. Procuring and installing EPRs is merely the starting point for this journey.
• The experience of the US, where many providers are several years ahead of the UK in EPR use, reveals the hill to climb: reaching meaningful use of EPRs requires time, investment and cultural change. NHS providers can learn from those organisations in the UK and abroad who are further ahead with their EPR journeys.
• The government urgently needs to set out an EPR strategy for the NHS to facilitate effective benefits realisation – both to ensure trusts are getting the basics right, and to help develop and deploy higher order functionalities including AI. This will be as important as any digitisation plan of the last 20 years. Trusts will ultimately bear some of the responsibility for good implementation and usage of EPRs, and should be asked to develop their own plans to sit alongside the national roadmap.
• There’s no avoiding the fact that capitalising on EPRs is going to require more funding. But the prize further down the line will be advances in care quality and productivity. Having already made significant investment in acquiring EPRs, it is essential that NHS organisations are now supported to realise these benefits.
• There’s no time to lose. While the few trusts still to put EPRs in place need support to do so, the next stage of this strategy cannot wait for that.

To estimate the extent to which inaccurate records are widespread, they commissioned BMG Research to conduct a nationally representative survey of 1,800 adults between 24 and 27 March 2025.

Concerningly, the survey found that nearly one in four (23%) adults have noticed inaccuracies or missing details in their medical records before. 

In most cases, people said they had noticed missing information, though some said their records contained incorrect information.

A quarter (26%) of those who have noticed inaccuracies in their records said their personal details were wrong. Many elements of NHS care involve individual staff members verbally carrying out ‘positive identification checks’ with patients, using date of birth information, especially if the person’s NHS number is unavailable at the time. A national safety body has found that misidentification can have serious consequences, such as the wrong surgery being carried out.

Other errors include inaccurate records of medications, diagnoses or treatments.

Healthwatch recommend the following actions.

1. Better record keeping. These stories and figures highlight the urgent need for improved record-keeping practices. This could be achieved by promoting relevant guidance and regulations by professional regulators, as well as better interoperability to ensure records are shared effectively. The government’s ambition to have a single patient record should help address this.
2. Promotion of people’s rights to get records amended. People's right to do this needs to be clearer, along with the legal reasons why services may still have to retain a record of contested information. It is also important to make more people aware that they can complain to the NHS or the Information Commissioner’s Office.
3. Clearer guidance for patients about how to change incorrect records. People told us how difficult it is to amend or remove inaccurate information in their records. 

Related reading on the hub:

• The digitalising of patient records — why patients MUST be involved