Frequently Asked Questions

An electronic patient record, known as an EPR for short, is a digital version of patients’ paper notes and records. 
Old-style paper records and outdated systems are replaced with a set of electronic information.
An electronic patient record may contain a patient’s medical history, diagnoses, medications, treatment plans, allergies, medical imaging, laboratory, and test results, and more.
The systems also include evidence-based tools and prompts that are used to inform decisions about a patient’s care, improve patient safety, and ensure efficient, compliant record keeping. 

We want to make records more accessible, support safety, improve patients’ experiences and provide the best care possible. 
The system is web-based, so it can be accessed by any trust device that connects to the internet. This means staff have more accurate, up-to-date, accessible records at their fingertips, which supports them to make effective, efficient, and consistent decisions. 
Having more information about patients in one place also means staff spend less time searching for records. The system will also reduce the burden of logging some data, because it captures certain information automatically. 
The electronic patient record will improve safety by displaying real-time information, providing decision-making tools, and alerting staff to issues.
Patients will experience many benefits, including less duplication and unneeded administration, smoother transitions between health and care settings, and more face-to-face time with staff.
The system will also create the ability to share data more effectively with health and care partner organisations, supporting informed, coordinated, joined-up care between local and regional services. 
The wider benefits for the trusts are described below.

Transforming how we work and embracing digital technology is a vital part of our ambitions to be outstanding. 
It is essential that we adapt to meet increasing demands, such as a growing and aging population, and continue the modernisation of our services.  
We must also improve our use of digital technology (sometimes referred to as our digital maturity), in line with other trusts, so we can continue to play our part in improvements across the wider health system both locally and regionally.
Nationally, in February 2022, the government outlined its ambition to have electronic patient records up and running in 90% of NHS trusts by December 2023. It wants the remaining 10% of trusts to be in the process of implementing electronic patient records by that date.

By working together, we can make these improvements more efficient, effective and affordable.
This is a collaboration that supports improvements to our services and capitalises on the strong links between the two organisations. 
It will also help to standardise some practices across the trusts and reduce variation in care quality.
East and Mid Cheshire already work together as members of the Cheshire East Partnership, and the Cheshire and Merseyside Integrated Care System (ICS). These organisations aim to support joined up working across the local area and wider region, and the Digital Clinical System will play an important role in this.
While this is a partnership with significant benefits, it must also be made clear that we are not talking about merging the organisations. This work is about collaboration between the two trusts that will bring huge improvements for staff, patients and their families.

The majority of the acute trusts’ clinical teams will use the Digital Clinical System, apart from those in our maternity teams. 

The electronic patient record will not replace the EMIS system where it is used in community services.

Critical care, also known as intensive care (or ICU), is included in the programme. The PAS elements will be deployed in Critical Care from go-live. However, the clinical processes will be deployed in a future phase.

Maternity – Our maternity services will benefit from the Digital Clinical System PAS, order-comms and prescribing, but they will not adopt the full electronic patient record. The programme includes interfacing Badgernet with MEDITECH Expanse.

Maternity service pathways are complex and difficult to effectively digitise. The DCS is currently unable to deliver a digital maternity record against these challenges and no current supplier is known to meet all of the objectives being set by the NHS leadership. As a result, we are instead conducting a separate review of the options for digital maternity records.

Community – The electronic patient record will not replace the EMIS system where it is used in community services. Locations that currently use EMIS (Community) will continue to do so - these are 'our of scope' of the DCS project. EMIS will instead work with the new electronic patient record and be interfaced with it. The exact details of this integration with EMIS will be agreed in the coming months and we will provide more information when it is available.

Record sharing with/from all care sectors such as mental health and social care is also included in the plans.

Our Trusts are aiming to launch the new electronic patient record in September 2024.

The Digital Clinical System is one of the largest programmes either trust has undertaken, so a significant amount of work must take place between now and autumn 2024 to develop new ways of working, build and test the system, train colleagues and ensure we are ready to go live. 

We have now begun the implementation phase of the project. This will involve development of new ways of working and the design and build of the Digital Clinical System. Our teams will then move on to testing and evaluating the system and seeking approval to go-live. There will also be a range of training before the launch of the system at each trust during autumn 2024 (with a target go live date of September 2024).

The programme is led by the Digital Clinical System team, which is working across both trusts.
Several teams at both organisations were involved in assessing the electronic patient record products and developing the business case for the programme.
We have organised demonstrations for specific staff groups to develop the plans, provide information and receive feedback. A Clinical Advisory Group has also been set up with key frontline colleagues who can help to inform the work.
The programme has been run through a series of groups and boards. Both trust boards have also been involved in the process. A review of the DCS governance is taking place and more information will be provided shortly.

During the implementation phase of the programme we are creating a change network across both trusts. This includes introductory and disovery workshops with key staff across the organisations. We will also be working with Digital Champions as a key part of this.
As the Digital Clinical System moves forwards, we will be involving more colleagues and teams in the development of the system. Information about staff involvement opportunities will be publicised in staff communications, as well as engagement events.

It is crucial that the development of this programme is staff-led, so we will continue to work with colleagues from both trusts to develop the details. 
In the coming months, we’ll provide more information about how staff can get involved in key areas of the programme, including the design, testing, training and participation in digital champions projects at both trusts. 
Digital champions and those involved in the development of the programme will receive early access to some details of the system, as well as enhanced training.
If you would like to be a Digital Champion, please contact jacqueline.cox@mcht.nhs.uk . To be involved in other areas of the programme, please contact DCSPMO@mcht.nhs.uk 
The DCS team is keen to engage will all staff and can be contacted on DCSPMO@mcht.nhs.uk – this includes the opportunity to receive presentations or question and answer sessions with the relevant colleagues.

We will provide support, through information and training, to ensure you are ready to move to the new ways of working. 
Champions and staff involved in the development and testing of the system will be offered early access to this.
The majority of the Digital Clinical System training will then take place in 2024.
When the electronic patient record is launched, on-the-ground staff will provide support to frontline staff. 
More details will be published when they are available.

Both trusts are in the process of establishing a network of digital champions. They will be the first point of contact for training and a frontline channel for communications and engagement.
Champions will:
•    Share information with colleagues;
•    Be the go-to colleague in their area for information / signposting;
•    Identify issues / concerns and raise them;
•    Share skills and support training.
Champions should be enthusiastic – but they don’t have to be a digital expert. They will be involved in many areas of the trusts’ digital work, including their digital strategies.
As part of their involvement in the Digital Clinical System, champions will receive training and early access to information. They will also contribute to the development and design of the system. 
 

If you would like to become a digital champion, contact jacqueline.cox@mcht.nhs.uk (for Mid Cheshire) and ecn-tr.digitalchampions@nhs.net (for East Cheshire).

A range of roles are being created to support the programme. We have now recruited dozens of colleagues to the DCS team.

Recruitment to further roles will take place over the coming months.

More information about the latest phase of jobs on offer is available at mcht.nhs.uk/DCSjobs

For more information, please visit jobs.nhs.uk and search for DCS, and see future staff comms and engagement events.

The trusts also have recruitment pages at East Cheshire (careersateastcheshire.nhs.uk) and Mid Cheshire (mcht.nhs.uk/work-us/current-vacancies).

The system will be used by all acute trust staff who need to view and record patient information. Staff will be granted specific access based on their roles.
Additionally, there will be access for patient-facing staff to view dashboard information and information that does not identify patients.
Many non-clinical staff will also be involved with the electronic patient record as it creates new ways of working and makes tasks easier to manage.
We will provide more information about the impact on specific roles as the programme progresses.

Community – The electronic patient record will not replace the EMIS system where it is used in community services. Locations that currently use EMIS (Community) will continue to do so - these are 'our of scope' of the DCS project. EMIS will instead work with the new electronic patient record and be interfaced with it.

We want to make records more accessible by giving you the right information, in the right place, at the right time. For this to be successful, we need all colleagues to embrace the Digital Clinical System.
Using an electronic patient record will help us to improve existing data capture and enable new types of data capture to improve patient care. The key to this will be designing the correct user experience.
By providing comprehensive, up-to-date, accurate information at your fingertips, we will aim to improve efficiency and create more time for care. 
For example, we will reduce the need to search through multiple sources of information - or request paper files - to find the records you need. 
We will also reduce burdens such as some data entry, as certain processes are automated and information will already be included from other areas of the system.
The system will also have a selection of digital tools that help staff to decide on the best care, maintain safety, coordinate patient flow, and improve appointment scheduling. 

This transformation provides opportunities for us to do things in new, more efficient ways. Where necessary, teams will design new workflows that can improve both care for their patients and the experience of our staff.
If teams are currently planning updates to their practices, this should continue as it will support the transition to the electronic patient record.
The Digital Clinical System team will work with staff from both trusts to ensure the right workflows are in place.

Staff will be given access to the electronic patient record, or parts of it, based on their roles.
It is a web-based system and can be used on different devices including mobiles, tablets, laptops and desktops. The system adapts its layout to those devices.
On your device, you’ll use one password to log into one system.
The layout and the way you navigate the information will be familiar to web users, with a simple browser-based display and touch-screen options for those using compatible devices. 
The layout of documents will look different to the current printed versions. The display will use some standardised sections and other parts of the layouts can be personalised for specific services. This personalisation ensures that clinicians in particular areas see the information they need, the way they want to see it.
The content that is displayed will be agreed through the programme’s Clinical Advisory Group and work with specific teams across both trusts.
Information will be available at your fingertips. So, for example, when a clinician records that they have prescribed something for a patient, it can be seen by other authorised users at different locations, at the same time.
As well as viewing and capturing information, the system will also have a range of digital tools that help staff to decide on the best care, maintain safety, coordinate patient flow, and improve appointment scheduling. 
All applications are fully integrated, so when you document in one location it becomes immediately available to all other authorised users, for more patient-centred care.

Some of the digital record systems employed by both Trusts will eventually be unable to support the provision of high-quality, modern health and social care. Where this is the case, we are replacing those products with the new solution.
Some existing solutions will be retained due to their nature. These retained solutions will then share data to and from the DCS, helping to enhance the benefits that the Digital Clinical System brings. 
The details of which systems are being kept and replaced will be finalised during the development stages of the programme. We will provide more details about this as the project moves forwards.

The electronic patient record will not replace the EMIS system where it is used in community services. Locations that currently use EMIS (Community) will continue to do so - these are 'our of scope' of the DCS project. Integration experts are looking at how the new system could interface with EMIS.

The system will provide the ability to interact with and share data more effectively with health and care partner organisations, supporting informed, coordinated, joined-up care between local settings and beyond. 
There are plans to integrate with other local and regional patient record systems, as well as proposals for record sharing with sectors such as mental health and social care. 
Services delivered on site by separate organisations will continue to use their own record keeping and we are exploring integration with those systems.
The exact details will be agreed as the design and testing work moves ahead. We will work with our Place and Integrated Care System partners to develop methods to share this data.

The programme includes the development of arrangements to maintain safe patient care at all times. Availability of critical patient records is paramount and mechanisms to ensure our staff have access to those records during periods of downtime form part of the DCS plan.

Current paper records will remain in offsite storage and will be catalogued in the system as patients present for future appointments. We only plan to scan a minimum amount of documentation into the DCS, with the majority of record keeping being electronic. Plans for a safe transition from the current paper records will be agreed through clinical governance and will be informed by clinical need. 

Access to records will only be available to authorised staff and there will be a strict policy supporting this. This includes features such as recording all login attempts.
Users will be subject to role-based access controls. 
The MEDITECH system also captures all views and/or changes to personal and health information, so it can be tracked.
The system will conform to legal and data protection rules and no data will be accessible to any outside agency. A Privacy Impact Assessment will be carried out, which includes data security.

The system does not need to be used on one specific device, it can be used on many including tablets, mobiles, laptops and desktops. The choice of device will be dictated by the task and available equipment. 
The electronic patient record will use a web browser to launch its display. The layout will then adapt to the device it is being used on.
There are a series of other minimum technical requirements for various devices including mobiles and tablets. For details, please contact the DCSPMO team on dcspmo@mcht.nhs.uk

We are carrying out work to assess the levels of equipment at both trusts and the need for new devices based on the introduction of the Digital Clinical System. 
This includes devices to view and capture records, and medical equipment that can link to the system.

Initially, medical devices in high acuity areas will provide a direct feed of information into the Digital Clinical System – for example in theatres, the emergency department and ICU.

A joint Digital Clinical System business case was developed, with both local and regional colleagues supporting the project.

We then followed a detailed, competitive procurement process. This approach ensured that all companies had the opportunity to bid for the contract.

Once the bids were received, a range of staff from both trusts assessed the products. This included seeing demonstrations and taking part in virtual site visits.

Following this thorough process, MEDITECH was then chosen as the preferred supplier.

MEDITECH is the supplier of the system that will be used for our new electronic patient record. It is a software and service company that develops information systems for healthcare organisations.
Founded in the United States in 1969, MEDITECH has also provided solutions to hospitals and healthcare organisations around the globe for decades, including UK, Canada, South Africa, Ireland, Australia, and several other countries.
MEDITECH works with organisations across the UK, including NHS trusts. The company recently celebrated its 30th anniversary of supporting healthcare in the UK. MEDITECH currently has systems in place at sites including Burton Hospitals, Liverpool Women’s, City Hospitals Sunderland, Alder Hey Children’s Hospital, and The Clatterbridge Cancer Centre NHS Foundation Trusts.
 

The Healthcare Information and Management Systems Society (HIMSS) is a non-profit organisation that promotes the best use of IT and management systems in the healthcare industry. HIMSS Level 7 is the highest level of ‘digital maturity’ (a measure of the successful use of digital technology) an organisation can achieve. 
Two of just three NHS trusts in the UK that have achieved HIMSS Level 7 inpatient certification are MEDITECH customers. Alder Hey is the first paediatric hospital in Europe to achieve this. Sunderland Royal was the first hospital in the north of England to be awarded HIMSS Stage 7 inpatient certification.
You can find out more information about HIMSS here.

Expanse is MEDITECH’s latest electronic patient record product. It’s the version that will be used by East and Mid Cheshire. 
Staff who have worked at other NHS trusts that use MEDITECH will not have experienced Expanse.
Expanse is described as a ‘next-generation, web-based platform that spans every care setting and provides a full view of the patient’s story’.
 

Alder Hey Children’s NHS Foundation Trust in Liverpool, one of Europe’s biggest and busiest children’s hospitals, will be one of the first MEDITECH NHS customers in the UK to use Expanse. It is planning a launch in September/October 2022.
South Tyneside and Sunderland NHS Foundation Trust is also planning to move from a previous MEDITECH product to the new Expanse system. 

The Digital Clinical System team is keen to engage with all colleagues and can be contacted via DCSPMO@mcht.nhs.uk 
Our team will also pass on more information about the programme in future staff communications, as well as engagement events.