In early March 2026, a conglomerate of 4 NHS Trusts in Somerset and Dorset introduced that that they had signed a £222 million contract with US-based digital well being document (EPR) large Epic, in a significant bid to switch outdated EPR and medical techniques with a single, federated, enterprise-wide resolution. The 4 trusts (Somerset NHS FT, Dorset Nation Hospital NHS FT, College Hospitals Dorset NHS FT and Dorset Healthcare College NHS FT) be a part of a collection of 14 different NHS trusts at present utilizing an Epic EPR. Epic has been fairly profitable in among the nation’s bigger, city NHS Trusts, akin to Higher Manchester, and Man’s and St Thomas’, and in addition has a wholesome presence in the remainder of London’s trusts. Nonetheless, selecting up this assortment of extra nationwide suppliers is a small step change for the provider, though this is not Epic’s first foray into the South West, having gained a contract with Royal Devon College Healthcare NHS FT and Torbay, and South Devon NHS FT.

EPR macro traits

EPRs play a central function within the digital technique of all trusts throughout the NHS, and as such a lot consideration is paid to selecting the best companion for this essential digital infrastructure. The course by which the NHS EPR market is transferring is evident, with a shift in the direction of bigger enterprise-wide options and in some circumstances even regional implementation. That is consistent with the broader development of consolidation persevering with within the English NHS, with the merger of six ICBs coming into impact from April, additional mergers anticipated earlier than the abolition of NHS England in April 2027, and the clustering of ICBs for improved effectivity. As healthcare organizations throughout the nation consolidate, the acquisition of digital techniques will consolidate as nicely.

This newest one from Epic is an ideal instance of this shift. Epic did have a bonus within the area, because it already had some regional presence with final yr’s win in Devon & Torbay. As is commonly the case within the NHS, organizations are influenced by their neighbors of their selection of expertise. This has put Epic’s EPR in a powerful place to realize extra belief within the Southwest.

Effectivity features and technical challenges

A uniform EPR throughout a number of trusts guarantees advantages: fewer techniques to log into; streamlined workflows for physicians; shared digital instruments to cut back duplicate information entry; extra constant entry to affected person data. These efficiencies are particularly significant in rural environments the place interoperability between places has traditionally been patchy.

However much more worth comes when information could be simply shared and accessed throughout all trusts from a single EPR vendor. Epic’s implementation of separate cases of its EPR could possibly be a stumbling block for information sharing throughout geographies. Different points additionally come up, akin to totally different affected person engagement apps required for various cases of the EHR, hindering the affected person expertise.

Epic has a precedent for sharing copies of its EPR. Nice Ormond Road Hospital was moved to the Royal Marsden occasion of Epic’s EPR in 2021, permitting for seamless information sharing and effectivity between the 2 trusts, and it is going to be attention-grabbing to see if there are future alternatives for larger interoperability between Dorset and Somerset, and Devon and Torbay.

Epic replaces a patchwork of options

Epic is changing a variety of totally different software program techniques with this step. The 4 trusts’ established EPRs embrace a minimum of System C and SystmOne from The Phoenix Partnership (TPP). Somerset Basis Belief was additionally one of many few remaining trusts within the UK to not have an EPR system in place, and Wes Streeting shall be happy to be one step nearer to reaching 100% EPR protection by the tip of 2026.

It is also not simply EHRs that shall be systematically changed by Epic’s resolution, but in addition affected person administration techniques (PAS) and different specialised medical techniques. Incumbent PAS distributors below fast risk of substitute embrace EMIS Well being (Optum), Intersystems, The Entry Group and IMS MAXIMS. It’s at present unclear which specialty medical techniques shall be changed by Epic, however it’s inevitable that a minimum of a few of these distributors shall be affected. With out additional data on which specialist medical modules shall be changed as a part of the deal, it’s troublesome to quantify the potential monetary financial savings achieved by eradicating the necessity for sure standalone medical software program, however it’s protected to imagine there shall be some effectivity features right here.

Aggressive issues

Though Epic is without doubt one of the leaders within the international EPR market alongside Oracle Well being (FKA Cerner) and the corporate has a formidable popularity, there are nonetheless some involved voices when a contract of this measurement is introduced. In its residence market of the US, Epic is dealing with a number of authorized battles surrounding its alleged monopoly within the US market. Though not practically as dominant in Britain, the considerations are nonetheless legitimate when two main gamers akin to Epic and Oracle cowl round 45% of the UK inhabitants’s acute hospital trusts (measured by inhabitants protection). Nonetheless, Epic may level out that distributors like System C and Nervecentre even have contracts that cowl the same portion of the inhabitants.

One other, maybe extra concrete, level raised by some considerations price. Epic is a primarily US-focused firm and its options on this core market are designed to facilitate elevated revenues for US healthcare suppliers, who function in a personal, revenue-driven system. The worth for its worldwide options is decided by the US market, and consequently, suppliers wanting to make use of Epic’s techniques in markets like Britain pay the US value. We see related contracts (by way of size and inhabitants protection) awarded for considerably much less worth, akin to Nervecentre profitable a ten-year contract to provide the EPR system to Mid Yorkshire Educating NHS Belief for £38m in February, or Altera (equipped by Perception Direct) profitable a seven-year contract from East Sussex Healthcare NHS Belief for £20m final August. Nonetheless, these tenders will not be immediately comparable, and it ought to be famous that Epic’s EHR and its related modules/performance could change a variety of medical/administrative techniques, however it’s nonetheless a viable level demonstrating the premium price ticket hooked up to Epic’s product.

The underside line

Epic’s deal between Somerset and Dorset is without doubt one of the most formidable nationwide/regional UK EPR contracts to this point. EPR contracts are nonetheless largely gained by giant suppliers, typically worldwide, regardless of the broader push to focus buying on SMEs. The scale of EPR initiatives (significantly ten-year, regional protection contracts akin to this) typically signifies that SMEs are much less more likely to be given desire, besides in distinctive circumstances.

For smaller or medium-sized suppliers, the important thing lies in differentiating not simply by performance, but in addition by flexibility of integration, ongoing help, affordability and the way nicely you’ll be able to connect with, or change, the evolving spine of the NHS digital structure. Incremental deployments and partnerships could also be extra sensible methods to construct belief and market presence than making an attempt to compete with Epic or Oracle for region-wide contracts.