Key takeaways

  • Properly resourced and credible clinical leadership is key to EPR optimisation.
  • Clinical leadership should represent all professions so their respective needs and goals are met.
  • Clinical leaders need to understand change and transformation as well as the basics of the underlying technology.

NHS trusts which are successfully optimising their EPR have dedicated clinical leadership and strong clinical engagement at every level. This means more than simply appointing a chief clinical information officer (CCIO). Ideally trusts should have a dedicated team with representation from different professional groups along with divisional roles and deputies as appropriate.

Credible clinical leadership is key. Leaders need to be experienced in their clinical field and be able to translate clinical needs into technology solutions. They hold the voice of the user and are able to understand the functionality and limitations of the EPR. For example, North West London NHS Foundation Trust has set up a sector wide junior doctors EPR group chaired by a deputy chief information officer (CIO) at Hillingdon who is also a junior doctor.

Clinical leaders need to understand not only the basics of technology but must also be conversant in change and transformation. As such they can influence and coach their peers to find solutions to challenges. Most clinicians we spoke with fell into their digital role and we heard a need to consider career development and progression in order to retain and support them.


Growing successful clinical digital leaders

Any EPR team needs to engage with different clinical roles which represent the breadth of the workforce. Digital leaderships roles should be properly resourced and built into a clinical leader's job description and work plan so they are able to consistently commit.

More broadly, clinical leadership also plays an important role in coordinating training, clinical safety and acting on the insights from the data created by the EPR. The Faculty of Clinical Informatics has published its findings into what makes successful digital clinical leaders, along with a model job description for recruiting a CCIO.

Boards shouldn't underestimate these skills and should actively support and empower their clinicians to seek development opportunities. For example one of NHS England’s Digital Academy programmes, the Digital Health Leadership Programme, is specifically designed to develop capability and capacity of digital change leaders. Ethical Healthcare's Minerva leadership programme is designed to empower women to understand their unique abilities and how they can use them to improve their digital leadership skills, while the grassroots One HealthTech community look to improve diversity in healthtech.

If recruiting new clinical leadership externally, trusts will want to ensure their recruitment processes reflects best practice in attracting a diversity of applicants. This may include, for example, checking job adverts for language that is biased.

Clinical leadership is also required at board level to ensure that the EPR is understood as a clinical concern and not solely that of the IT department. It is the responsibility of the whole board, and in particular the chief medical and nursing officers, to explain any EPR changes, benefits or delays to the clinical workforce.

We can only [optimise the EPR] by actually sitting down and really understanding the processes. A lot of it is around process mapping […] and many specialties have sector wide clinical working groups that meet regularly […] and then drive change jointly.

Dr Rakesh Patel    Chief Clinical Information Officer, The Hillingdon Hospitals NHS Foundation Trust

Case study

Leadership helps bring people on the journey

I see the CCIO role as the bridge between the doers and the digital team. There's lots of people in the trust with ideas about how a digital solution would make life easier and improve care for patients. I often find myself directing them to something we already have they didn't know about or putting them in touch with the people who can make their vision a reality.


Alder Hey Children's NHS Foundation Trust is a specialist NHS trust in the North West that cares for over 330,000 children, young people and their families each year. In 2015 they opened a state-of-the-art hospital alongside a brand-new research, innovation and education centre which aim to bring together excellent care, technology and design and provide the best possible healing environment for children and their families.

The trust has focused on clinical leadership to ensure the development of their next generation EPR improves the working lives of its users. This has meant ensuring attention on things that improve staff experience such as the number of clicks needed to achieve a task whilst keeping an eye on innovations and the future. Focusing on the experience of clinicians and what is most important to them has meant that the next generation EPR aims to meet their needs, resulting in better data entry, data quality and staff buy-in.

Alder Hey has a growing team of medics, nurses and allied professionals who work as clinicians but also have dedicated time to work with the digital team to ensure optimisation efforts are clinically useful. The trust has created associate clinical digital roles for each of their clinical divisions after recognising that one CCIO was not sufficient.

This approach recognises that there are different challenges and opportunities in each specialty and that optimisation requires a deep clinical understanding of the particular clinical areas in question.