In early March 2026, a conglomerate of four NHS Trusts in Somerset and Dorset announced that they had signed a £222 million contract with US electronic patient records (EPR) giant Epic, in a radical move that seeks to replace legacy EPR and clinical systems with an enterprise-wide federated solution. The four trusts – Somerset NHS FT, Dorset Country Hospital NHS FT, University Hospitals Dorset NHS FT and Dorset Healthcare University NHS FT – join a list of 14 other NHS trusts currently employing an Epic EPR. Epic has had reasonable success in some of the country’s largest urban NHS trusts, such as Greater Manchester and Guy’s and St Thomas’, as well as having a healthy presence in the rest of the London trusts. However, acquiring this collection of more rural providers is a slight change for the supplier, although it is not Epic’s first foray into the South West, having won a contract with Royal Devon University Healthcare NHS FT and Torbay, and South Devon NHS FT.
EPRs play a central role in the digital strategy of all NHS trusts and, as such, much attention is paid to choosing the right partner for this critical digital infrastructure. The direction the NHS EPR market will take is clear, with a shift towards larger enterprise-wide solutions and even regional implementation in some cases. This aligns with the wider trend of consolidation underway across NHS England, with six ICBs merging from April, with further mergers expected before NHS England abolishes in April 2027 and ICBs being grouped together to improve efficiency. As healthcare agencies across the country consolidate, the acquisition of digital systems will similarly consolidate.
This latest example from Epic is a perfect example of this change. Epic had an advantage in the region, having already had some regional presence with Devon & Torbay’s victory last year. As is often the case with the NHS, organizations are influenced by their neighbors in their choice of technology. This has put Epic’s EPR in a strong position to win over more trusts in the South West.
A unified EPR across multiple trusts promises benefits: fewer systems to log into; optimized workflows for physicians; shared digital tools to reduce duplicate data entry; more consistent access to patient records. These efficiencies are especially significant in rural settings where interoperability between sites has historically been spotty.
But additional value arises when data can be easily shared and accessed across all trusts from a single EPR provider. Epic’s implementation of separate instances of its EPR may be an obstacle to data sharing between different geographic areas. Other difficulties also arise, such as the need for different patient engagement applications in different instances of your EPR, making the patient experience difficult.
Epic has a precedent for sharing instances of its EPR. Great Ormond Street Hospital moved to Royal Marsden’s Epic EPR instance in 2021, allowing for smoother record sharing and efficiencies between the two trusts, and it will be interesting to see if there are future opportunities for greater interoperability between Dorset and Somerset, and Devon and Torbay.
Epic is replacing several different software systems with this move. The incumbent EPRs in all four trusts include at least System C and SystmOne from The Phoenix Partnership (TPP). Somerset Foundation Trust was also one of the few remaining trusts in the UK without an EPR system in place, and Wes Streeting will be delighted to now be one step closer to achieving 100% EPR coverage by the end of 2026.
Additionally, not only will EPRs be systematically replaced by Epic’s solution, but also patient management systems (PAS) and other specialized clinical systems. Current PAS vendors under imminent threat of replacement include EMIS Health (Optum), Intersystems, The Access Group and IMS MAXIMS. It is currently unclear which specialized clinical systems will be replaced by Epic, but it is inevitable that at least some of these providers will be affected. Without more information about which specialized clinical modules will be replaced as part of the deal, it is difficult to quantify the potential financial savings achieved by eliminating the need for some standalone clinical software, but it is safe to assume that there will be some efficiencies here.
While Epic is one of the leaders in the global EPR market along with Oracle Health (FKA Cerner), and the company maintains a formidable reputation, there are still some concerned voices that chime in whenever a contract of this scale is announced. In its home US market, Epic faces multiple legal battles surrounding its perceived monopoly of the US market. While not as dominant in the UK, the concerns are still valid when two big players like Epic and Oracle cover approximately 45% of the UK population’s acute care hospital trusts (by population coverage). Epic, however, could point out that vendors like System C and Nervecentre also have contracts that cover a comparable segment of the population.
Another, perhaps more specific, point raised by some is cost. Epic is a primarily US-focused company and its solutions in this core market are designed to facilitate increased revenue for US healthcare providers, who operate in a private, revenue-driven system. The price of its international solutions is set by the US market, and as a result, in markets like the UK, vendors who want to use Epic’s systems pay the US price. We see comparable contracts (in terms of duration and population coverage) awarded for significantly less, such as Nervecentre winning a ten-year contract in February to supply the EPR system to Mid Yorkshire Teaching NHS Trust for £38 million or Altera (supplied by Insight Direct) winning a seven-year contract from East Sussex Healthcare NHS Trust last August for £20 million. However, these tenders are not directly comparable, and it should be noted that Epic’s EPR and associated modules/functions may replace a number of clinical/administrative systems, but it is still a viable point that demonstrates the premium price that Epic’s product boasts.
Epic’s deal between Somerset and Dorset is one of its most ambitious UK rural/regional EPR contracts yet. EPR contracts are still largely won by large, often international, suppliers, despite wider pressure for procurement to focus on SMEs. The scale of EPR projects (particularly decade-long regional coverage contracts like this one) generally means that SMEs are less favoured, except in exceptional circumstances.
For smaller or medium-sized providers, the key lies in differentiating not only on functionality but also on the agility of integration, ongoing support, affordability and how well it can connect to or replace the evolving backbone of the NHS digital architecture. Incremental deployments and partnerships may be more realistic ways to build trust and market presence than trying to go head-to-head with Epic or Oracle for region-wide contracts.
“Epic lands £222m federated EPR contract in Somerset and Dorset” was created and originally published by Verdict, a brand owned by GlobalData.
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