In early March 2026, a conglomerate of four NHS Trusts across Somerset and Dorset announced that they had signed a £222m contract with US-based electronic patient records (EPR) giant, Epic, in a sweeping move looking to replace legacy EPR and clinical systems with one, federated, enterprise-wide 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 roster of 14 other NHS trusts currently employing an Epic EPR. Epic has been reasonably successful in some of the country’s bigger, urban NHS Trusts, such as Greater Manchester, and Guy’s and St Thomas’, as well as having a healthy presence across the rest of the London trusts. However, picking up this collection of more rural providers is a slight step change for the vendor, although not Epic’s first foray into the Southwest, having won a contract with Royal Devon University Healthcare NHS FT and Torbay, and South Devon NHS FT.
EPR macro trends
EPRs play a central role in the digital strategy of all trusts across the NHS, and as such, a great deal of attention is paid to picking the correct partner for this critical digital infrastructure. The direction of travel for the NHS’s EPR market is clear, with a shift towards larger enterprise-wide solutions, and even regional implementation in some instances. This aligns with the wider trend of consolidation ongoing across England’s NHS, with the merger of six ICBs effective from April, further mergers expected ahead of NHS England’s abolition in April 2027, and the clustering of ICBs for improved efficiency. As healthcare bodies across the country consolidate, procurement of digital systems will similarly consolidate.
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This latest example from Epic is a perfect example of this shift. Epic did have an advantage in the region, since it already had some regional presence with last year’s Devon & Torbay win. As is often the case with the NHS, organisations are influenced in their choice of technology by their neighbours. This has put Epic’s EPR in a strong position to win across more trusts in the Southwest.
Efficiency gains and technical challenges
A unified EPR across multiple trusts promises benefits: fewer systems to log into; streamlined workflows for clinicians; shared digital tools to reduce duplicate data entry; more consistent access to patient records. These efficiencies are especially meaningful in rural settings where site-to-site interoperability has historically been patchy.
But further value comes when data is easily shareable and accessible between all trusts on a single EPR vendor. Epic’s implementation of separate instances of its EPR can be a stumbling block for data sharing between different geographic areas. Other difficulties also arise, such as different patient engagement apps required across different instances of its EPR, which hinders patient experience.
Epic does have precedent for sharing instances of its EPR. Great Ormond Street Hospital was moved onto the Royal Marsden’s instance of Epic’s EPR in 2021, allowing for more seamless record sharing and efficiencies between the two trusts, and it will be interesting to see if there are future opportunities for increased interoperability between Dorset and Somerset, and Devon and Torbay.
Epic replaces a patchwork of solutions
Epic is replacing a number of different software systems with this move. Incumbent EPRs across the 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 across the UK with no EPR system implemented, and Wes Streeting will be pleased that he is now one step closer to achieving 100% EPR coverage by the end of 2026.
It is also not just EPRs that will be systematically replaced by Epic’s solution, but also patient administration systems (PAS) and other speciality clinical systems. Incumbent PAS vendors under imminent threat of replacement include EMIS Health (Optum), Intersystems, The Access Group, and IMS MAXIMS. It is currently unclear what specialist clinical systems will be replaced by Epic, but it is inevitable that at least some of these vendors will be affected. Without further information on which specialist clinical modules will be replaced as part of the deal, it is difficult to quantify the potential financial savings gained by removing the need for some standalone clinical software, but it is safe to assume that there will be some efficiencies here.
Competitive concerns
While Epic is one of the leaders of the global EPR market alongside Oracle Health (FKA Cerner), and the company maintain a formidable reputation, there are still some concerned voices chiming in whenever a contract of this scale is announced. In its home market of the US, Epic is facing multiple legal battles around its perceived monopoly of the American market. While nowhere near as dominant in the UK, concerns are still valid when two big players such as Epic and Oracle cover approximately 45% of the UK population’s acute hospital trusts (by population coverage). Epic, however, could point out that vendors such as System C and Nervecentre also have contracts in place covering a comparable segment of the population.
Another, perhaps more concrete, point raised by some is around cost. Epic is a primarily US-focused company, and its solutions in this core market are designed to facilitate increased revenue for American healthcare providers, which operate in a private, revenue-driven system. The price point for its international solutions is set by the US market, and as a result, in markets like the UK, providers that want to use Epic’s systems pay the American price. We see comparable contracts (in terms of length and population coverage) awarded for significantly less value, such as Nervecentre winning a ten-year contract in February to supply the EPR system to Mid Yorkshire Teaching NHS Trust for £38m or Altera (supplied by Insight Direct) winning a seven-year contract from East Sussex Healthcare NHS Trust last August for £20m. However, these tenders are not directly comparable, and it must be noted that Epic’s EPR and associated modules/functionality can replace a number of clinical/administrative systems, but it is still a viable point demonstrating the premium price tag that Epic’s product boasts.
The bottom line
Epic’s Somerset and Dorset deal is one of its most ambitious rural/regional UK EPR contracts yet. EPR contracts are still, for the most part, being won by large vendors, quite often internationals, despite the broader push for procurement to focus on SMEs. The scale of EPR projects (particularly decade-long, regional coverage contracts like this one) generally means SMEs are less often favoured except in exceptional circumstances.
For smaller or mid-sized vendors, the key lies in differentiating not just by functionality but by integration agility, ongoing support, affordability, and how well you can plug into, ot replace, the evolving backbone of 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 whole-region contracts.
