- At least nine NHS acute trusts are expected to undergo major Electronic Patient Record (EPR) transitions this year
- Post-go-live data remediation typically costs around £1.5 million per trust
- Issue linked to historic patient data disrupts waiting list management and creates extra work for hospital staff
- EPR transitions have been linked to patient safety issues and poor system efficiency
London, UK. NHS trusts across England could spend more than £13.5 million in 2026 correcting data problems that emerge after hospitals transition to a new electronic patient record (EPR) system, according to a new analysis launched today by healthcare data specialists, MBI Health.
Based on the number of EPR programmes expected to go live in 2026 and typical remediation costs seen in previous transitions, the analysis suggests the financial impact of post‑go‑live data correction could be substantial and largely avoidable.
The estimated £13.5 million is equivalent to funding:
An EPR transition refers to the changeover from legacy hospital systems or an existing EPR system to a new digital platform, including the transfer of patient data, clinical workflows and operational processes. While EPRs are a central part of NHS digitisation, hidden problems in legacy data often only become visible after the new system goes live. When that happens, trusts can face months of additional work to correct records, stabilise reporting and rebuild confidence in the data used to manage patient care.
Barry Mulholland, CEO of MBI Health said, “EPRs are central to the NHS’s overall future, but we’ve seen that many of the biggest risks to these programmes are already embedded in the legacy data that organisations inherit. When those issues are discovered only after go-live, they can destabilise operational systems for months and require expensive fixes. Treating data readiness as a core part of implementation helps ensure digital transformation delivers the benefits staff and patients expect.”
One of the biggest operational risks is disruption to patient tracking lists (PTLs), which hospitals use to monitor where patients are in their treatment pathway. If records are duplicated, incomplete or migrated incorrectly, trusts can struggle to manage waiting lists accurately and understand which patients need action first. This can lead to poorer outcomes for patients that wait longer for treatment, and frustration for staff.
MBI Health’s analysis of previous EPR transitions suggests PTLs can increase by around 25% on average after go-live. This can reflect duplicated records, incomplete data or referrals ending up in the wrong place during migration. Because PTLs underpin Referral to Treatment (RTT) management, disruption in these records can make it harder for trusts to manage waiting list performance and recover elective care.
Dr Marc Farr, chair of the NHS Chief Data and Analytical Officer Network said, “Too often, data experts are brought in too late in EPR programmes, when key decisions have already been made. If we want these transformations to succeed, data and analytics leaders need to be at the table from the outset, shaping how systems are designed, implemented and data assured. EPRs represent one of the largest digital and data investments NHS organisations will make. When issues emerge after go-live, they can take significant time and resource to resolve, delaying benefits and adding pressure to frontline teams. The reality is that many of these challenges originate long before implementation. By prioritising data quality and integrity and readiness early, organisations can reduce risk, avoid disruption, and ensure these programmes deliver the value that patients and staff need.”
The risks of EPR transitions extend beyond remediation costs. A recent national review[iv] confirmed that new EPR programmes can contribute to missed, delayed or incorrect patient care due to issues in implementation, usability, training and optimisation. One example involved a four-year-old girl who received five incorrect doses of blood-thinning medication after an ePMA system failed to flag the error, leading to bleeding around her brain. The review also flagged inconsistent terminology, missing safety functions, lax governance and low staff involvement during EPR rollout.
Post go‑live, the strain continues: staff are often diverted into manually checking and correcting records, validating data and compensating for system failures, adding pressure to already stretched teams.
Helen Hughes, Chief Executive at Patient Safety Learning said,”Reliable patient records are fundamental to safe care, and when things go wrong, there is a risk that important clinical details are overlooked or that patients experience delays in their care. Investigations into EPR-related incidents have shown that these risks can contribute to situations where patients fall through the cracks, receive the wrong treatment, or come to harm in other ways, highlighting the importance of managing patient safety risks carefully during major digital transitions.”
The £13.5 million estimate captures only the direct cost of post-go-live data remediation. It does not include wider impacts such as lost productivity, delayed benefits realisation, additional administrative burden for frontline teams, or knock-on effects for patient flow and operational performance.
