- Investing in a productive working relationship with a supplier is key to facilitating ongoing improvement in your EPR.
- Transparency and clarity over how you will work to improve the EPR avoids the risk of exponential costs to your trust.
- There are productivity benefits and savings to be made by cooperating with other trusts which have the same EPR.
Developing and maintaining good working relationships with EPR suppliers is a critical ingredient of successful EPR optimisation.
Ideally you should be setting the foundations for a good working relationship from the earliest stages of market engagement with prospective EPR suppliers. This might mean asking them to describe how they work on ongoing optimisation with current NHS clients and then speaking with other NHS trusts to find out how this works in practice. If you can, arrange a board-to-board visit to understand the lessons learned by others.
You'll need to be clear what constitutes change requests that are included within the contract and those which will incur additional costs. It is also important to understand the extent to which the supplier will allow you to work with third party providers and the implications for device integration. Boards should seek assurance that these sorts of issues are identified and incorporated into contracts from the outset.
Fewer requests for bespoke configuration generally mean you'll experience fewer charges over time. But that doesn't mean you shouldn't ask for changes. As a board member, you should expect your CIO and procurement team to be assessing these factors from the outset to maximise optimisation opportunities and manage costs over the lifecycle of the contract.
Your strategic relationship with your suppliers [is critical], treat them as a commodity provider and you won't get much out of them or be successful in embedding their products constructively in your trust […] you need to bring your suppliers with you and help them to understand your business so they can contribute their best.Chief Information Officer, Berkshire Healthcare NHS Foundation Trust
There are productivity and cost savings to be made by collaborating with other NHS organisations to join up your optimisation requests so they only have to be done once by the supplier. The board should be aware which trusts are working with the same EPR supplier within their ICS and ideally across their region too.
Finally, investing time in a win-win supplier relationship can pay dividends and should not be underestimated. Having a dedicated product owner to do this is worth the time and effort.
Collaborating across trusts for cost-effective optimisation
One of the things we have learnt is there are always going to be commonalities between trusts. When you start talking to other trusts you find they dislike a particular pain point as much as you do. So we've agreed that rather than us always doing our change requests individually, there are common requests that we can submit together. We all chip in and reduce the load.Product manager - ePCR, London Ambulance Service NHS Trust
London Ambulance Service (LAS) is the busiest emergency ambulance service in the UK, serving the nine million people who live, work in or visit the city. They were one of the last ambulance provider trusts to switch from paper to digital and are currently extending and optimising their Cleric Electronic Patient Care Record (ePCR).
With four out of the ten NHS ambulance providers in England using Cleric EPR, they decided to come together to create a joint user group. Every two months they have a two-part meeting where the trusts meet to discuss their needs followed by a meeting with Cleric. In practice, this means that they agree and prioritise changes together, saving money whilst helping the vendor focus their resources on the most impactful changes.
As a result of coming together as a user group, Cleric and the trusts continue to optimise the EPR software based on user feedback, which means that emergency responders can easily use the ePCR on their iPads with a good user experience. It also allows the group to propose and debate large scale developments that might otherwise be too significant in scale or cost for any one of the trusts to consider alone.