NHS spending £230m annually on paper patient records

New analysis by Future Health Intelligence (FHI) has found that despite efforts by successive governments to digitise patients records, the vast majority of NHS trusts still spend large sums to maintain paper medical records. 

Government data analysed by FHI shows the NHS in England spent £230.5m on paper records in 2023-24, the most recent year data is available for. This is despite some 94% of trusts now having electronic patient records (EPRs).

The research comes after last week’s publication of the 10 year plan for the NHS, which gives digitisation a pivotal role in achieving NHS modernisation and improving productivity, and points to how difficult it is to eliminate paper records even after having digitising.

In 2013 the then health secretary Jeremy Hunt called for the NHS to be paperless by 2018.  Twelve years on from the target, trusts are still spending nearly a quarter of a billion pounds a year on paper records.

The new report, ‘Medical Records and Digital Maturity’, also shows there is no statistical significant correlation between the digital maturity of an NHS trust, as measured by NHS England’s Digital Maturity Assessment and the amount a trust spends on paper medical records. Higher digital maturity trusts were just as likely to be big spenders on paper medical records.

Instead, the size of a hospital trust in terms of number of beds was a more reliable indicator of their spend on paper medical records. 

Only a handful of high digital maturity hospitals have managed to eliminate, or nearly eliminate, paper records entirely, or reduce spending to the bare minimum required to retain historic records required for medico-legal reference. 

The lowest spenders tended to be smaller specialist tertiary hospitals.

One notable exception and success story is Cambridge University Hospitals NHS FT, which despite having over 1,100 beds also has one of the lowest spends on paper medical records in the country at £193,000.

The prestigious trust is one of the most digitally advanced in England, having been the first to implement the Epic EPR system a decade ago.

By contrast, Barts Health NHS Trust, with 2,133 beds, which implemented an Oracle EPR over a decade ago has one of the highest spends on paper medical records in the country at £8.6m.

The NHS trust that spends highest spend on paper medical records in the country is Northern Care Alliance NHS FT, with 1617 beds, and an annual spend of £9.4m.

Future Health Intelligence analysed Estates Return Information Collection (ERIC) data from NHS England for the report.

‘Medical Records and Digital Maturity’ is available here.

Future Health Intelligence is the new independent market intelligence and data business, created in January 2025 from the former intelligence arm of Digital Health Intelligence. The company is the leading source of data and analysis on the fast-evolving UK health IT market.