Cheshire trusts optimising shared EPR following go-live

East Cheshire NHS Trust and Mid Cheshire Hospitals NHS Foundation Trust have shared that they are continuing to optimise their shared electronic patient record (EPR) system months after launch.

Speaking at Digital Health Rewired 2026 on 25 March, Danny Roberts, chief information officer at East Cheshire NHS Trust, said that the trusts entered an optimisation phase in September 2025 which will continue until June 2026, following the go-live of the MEDITECH Expanse system in June 2025.

He said that “go-live is the start, not the finish” and that “it’s one thing to get the EPR, it’s then settling it in, getting people used to it, and really starting to sweat the asset”.

Roberts added that the programme has “continued at pace” since launch, with the trusts working to address workarounds, improve functionality and deliver elements of the original scope that were not implemented at go-live.

“We’ve been trying to do a lot of optimisation at the same time as a major upgrade,” he said.

This, Roberts said, is “perhaps our biggest challenge” as it requires the same level of preparation as a big go-live and led to eight hours of downtime for the two trusts earlier this month.

The shared EPR was delivered across East Cheshire and Mid Cheshire through a single programme, with Roberts highlighting collaboration as a key enabler of the project.

“We were each too small, really, to deliver a large-scale EPR implementation on our own,” he said, adding that the trusts wanted to work together because they both had ageing systems, similar levels of digital maturity, and wanted “to avoid duplication and reduce delivery risk”.

The two trusts developed a joint governance model and a shared ‘Digital Clinical System (DCS)’, designed to standardise processes and documentation across both sites.

“It’s not the East way or the Mid way — it’s the DCS way,” Roberts said, adding that achieving standardisation across organisations with different cultures and priorities had been “really hard”.

As part of the post-go-live phase, Roberts told Rewired that reporting and data quality were key challenges, warning that some issues had only become fully visible once the systems were live.

“The way the applications are built, you can’t really do your reporting until you’ve gone live,” he said, and that “the real issue is data quality”.

Both Cheshire trusts experienced challenges with outpatient productivity and reporting following the shared EPR launch.

Roberts said that inconsistencies in data is entry can have a direct impact on performance reporting, including activity and waiting list metrics.

“You get to a position where somebody is not doing what they need to do in a timely manner, they’re not just keying in the data at the right time in the right place.

“That’s been a huge challenge, particularly at the moment as we’re all under scrutiny about performance and waiting lists and RTT,” he said.

Roberts emphasised the importance of strong leadership, clinical engagement and realistic expectations when undergoing a major programme, warning delegates that “you will always need more resource than you put in the business case”.