Queen Victoria Hospital NHS Foundation Trust (QVH) is a leading specialist centre providing reconstruction and sleep services across the South East and beyond through its hub and spoke outreach model. It also provides essential healthcare for local people including a Minor Injuries Unit (MIU) and therapy services.

The hospital receives more than 227,000 patient visits each year (2025 figures) including inpatient and outpatient attendances. High patient throughput, specialist pathways and cross‑organisational working with partner hospitals was placing increasing pressure on paper‑based processes and fragmented digital systems.

As part of the trust’s commitment to digital transformation, it wanted a unified Electronic Patient Record (EPR) system, which would bring clinical information together digitally in one place to help staff provide safer, more efficient patient care, whilst reducing reliance on paper and the need to use multiple systems.

Outcomes up to the end of May 2026

• Enhanced patient safety and clinical outcomes through improved decision-making, reduced medication and documentation errors supported by the implementation of electronic prescribing and medicines administration (ePMA). Nearly 40,000 medicines have been prescribed and over 87,000 administered electronically following go-live.
• Increased operational efficiency by reducing duplication across teams, streamlining workflows (including paediatric pre-assessment and admission), and significantly cutting paper documentation from day one, with nearly 100,000 clinical documents created digitally.
• Improved access and visibility with real-time patient tracking across services and direct access through the core patient record to key systems such as imaging and medical photography.
• Safe, uninterrupted go-live and clinically safe implementation with no loss of productivity, maintaining 99.5% MIU performance, no breaches, and no cancellations in Outpatients or Theatres, during go-live due to thoughtful pre-planning.
• Sustainability gains achieved through a substantial reduction in paper usage, with over 800,000 sheets of paper avoided, equivalent to saving more than 100 mature trees and up to 4.2 tonnes of carbon dioxide since go live.

The challenge of becoming paper‑lite whilst maintaining performance

Until recently, patient notes and clinical documentation at QVH were predominantly paper-based. Although some digital systems were in place, staff frequently logged into multiple standalone applications to access patient information. This resulted in duplication, increased administrative effort and the risk of errors when patient information was written down or re-entered manually, particularly in high-pressure settings such as Theatres, MIU, inpatient wards (adult and paediatric) and pharmacy.

In some areas, including MIU, patient records remained entirely paper-based, with limited access to scanned or digitised documents. This created challenges in accessing historical patient information and resulted in inefficiencies in care delivery. QVH identified a need to reduce paper handling, streamline workflows and establish a single, real-time source of patient data. Any digital change needed to be delivered without compromising patient safety or operational performance.

A significant digital transformation

In 2024, QVH signed a five‑year contract with Altera Digital Health to implement the Altera electronic patient record (EPR) platform across the trust, aligning with NHS England’s requirement for all trusts to have an EPR by March 2026.

Where possible, the trust chose to replace siloed health IT systems, legacy patient administration tools and core clinical systems, supported by Altera Managed Services.

Following a trust‑wide staff vote, the system was locally branded as Archie EPR, a tribute to Sir Archibald McIndoe, whose pioneering surgical techniques developed at QVH during WWII paved the way for modern plastic surgery. Archie EPR went live in November 2025, representing the most significant digital transformation ever undertaken by the trust.

Defining what success would look like

QVH defined success against three measures: maintaining patient safety and operational performance during go‑live; a rapid reduction in paper usage; and improving access to patient information to reduce duplication.

Rather than relying on formal baseline metrics, the trust recognised that many services were fully paper-based prior to go-live, with limited access to digitised records. This created variability in access to patient information and inefficiencies in workflows.

Post go-live, improvements have been observed through increased digital adoption, improved accessibility of patient data, and enhanced visibility across care pathways.

A consolidated clinical “big bang” approach

QVH introduced the new clinical system in a single phase, avoiding prolonged use of dual paper and digital systems and enabling a clearer transition for staff.

Planning for the programme began approximately six months before go-live led by the Chief Medical Officer and supported by a multidisciplinary EPR Programme Team including clinical leadership (CNIO, CCIO), change teams and operational stakeholders. Staff engagement was supported through webinars, demonstrations, workshops, Team Talk sessions, weekly staff newsletters and visual communications such as screensavers. A strong internal identity, including an Archie EPR logo and “Team Pink” branding for Digital Champion visibility during go-live supported awareness and engagement.

Training and go‑live support

Training was primarily delivered through e-learning, supported by follow-up sessions and practical support. For go-live:

• 97% of staff completed training (significantly above the 85% NHS England target)
• 120 Digital Champions were deployed across the organisation
• 24/7 on-site support was provided for the first three weeks
• A central Command Centre enabled real-time issue resolution

This hands-on support model, combined with rapid system improvements during go-live, helped build staff confidence and encouraged early adoption. A clinical safety programme supported by SafeHand and in partnership with NHS England ensured patient safety throughout the transition.

“I witnessed one of the smoothest transitions over from analogue to digital, and we couldn’t have done it without our staff embracing this journey. It has been a privilege to be part of this work bringing together QVH staff, digital and technical contractors, Altera Digital Health, NHSE teams and support from neighbouring trusts.”

Kirsten Timmins
Chief Operating Officer at QVH

Making an impact from day one

The implementation of Archie EPR was clinically safe, with no reduction in activity, no cancelled clinics or procedures, and no adverse impact on productivity during or after go‑live. This was a critical success measure for the trust, demonstrating that a full EPR deployment could be delivered safely whilst maintaining continuity of care and operational performance.

In the first months following go‑live, clinicians created nearly 100,000 clinical documents and prescribed nearly 40,000 medicines and over 87,000 administrations electronically through EPMA. Staff accessed other trust systems over 430,000 times using integrated patient context links, improving access to information and reducing duplication and transcription risk.

Digital adoption increased rapidly across the organisation. Teams achieved around 90% digital working whilst maintaining 99.5% performance against the four‑hour standard. Across the trust, day‑forward scanning reduced by 40%, improving the timeliness and availability of clinical records. In total, 834,000 sheets of paper have been avoided to date, equivalent to saving around 100 mature trees and up to 4.2 tonnes of carbon dioxide.

A new way of working

The Sunrise EPR platform has contributed to improved coordination and delivery of care by providing more timely access to patient information through a single, integrated record. Whilst the system has not fundamentally changed how teams plan care, it has improved visibility, consistency and information sharing across services.

Benefits are being realised including improved visibility of patient pathways across inpatient wards, theatres and outpatient services, shared access to operational data and dashboards, and real‑time insight into patient status and schedules. This has supported closer collaboration between clinical teams and enabled more proactive coordination of care.

Standardised documentation has delivered benefits in safeguarding and paediatric services. Within paediatric services, digital pre‑assessment and admission documentation has replaced multiple paper booklets, reducing duplication and saving nursing time. This has improved workflow efficiency and documentation quality, while strengthening the identification of safeguarding concerns for both adults and children.

“Major digital change requires meticulous attention to programme detail and close engagement with stakeholders. I am incredibly proud of the excellent teamworking by QVH staff who were generously supported by colleagues across the NHS and from NHS England itself through go-live. I have no doubt whatsoever that this is what led to the successful delivery of our EPR on schedule and, with no adverse impact on clinical safety or productivity.”

Tamara Everington
Chief Medical Officer at QVH

Clinical leadership and safety

Strong clinical leadership underpinned the clinically safe implementation of Archie EPR. Early indicators show improvements in documentation quality and legibility, reduced transcription between systems, and better access to patient history at the point of care. Whilst longer‑term clinical outcome measures will continue to be monitored, early feedback indicates increased staff confidence in the accuracy and availability of clinical information.

Romana Balle, Chief Nursing Information Officer at QVH, explained: “Clinical leadership was essential to configure Archie EPR in a way that genuinely supports care delivery. By involving clinicians in workflow design and testing, we reduced reliance on paper and gave staff greater confidence in the information available to them at the point of care. Our biggest learning has been the importance of visible leadership and peer support alongside the technology.”

Mark Hutchinson, Executive Vice President at Altera Digital Health (UK & EMEA), said: “The new EPR is providing a single source of patient data, giving clinical teams comprehensive, real‑time information at their fingertips to support better decision‑making and improve the safety and reliability of patient care. This is a fantastic achievement, made possible by the team’s unwavering commitment to a programme that has remained patient‑focused, clinically led and digitally enabled. Importantly, it also establishes a strong digital platform for continued optimisation and innovation, enabling the trust to build, expand and evolve digitally enabled models of care over time.

Continuing the digital journey

Since its launch, QVH continues to optimise Archie EPR as part of a structured digital transformation programme. Current and planned work includes further development of pre‑assessment pathways and critical care (CCU) pathways and deeper integration with additional clinical systems and workflows, and enhancements to reporting, dashboards and operational visibility. The trust is also progressing patient‑facing digital services including the adoption of Altera Patient Administration functionality and is exploring the use of AI‑enabled technologies.

Over the next 12 to 24 months, the trust will focus on further reducing paper usage and scanning, improving medication safety and workflow efficiency, and enhancing productivity across outpatient, inpatient and surgical services. Success will be measured by releasing more staff time for direct patient care, alongside improvements in patient experience, safety and sustainability.

The launch of Queen Victoria Hospital NHS Foundation Trust’s first EPR system represents an important milestone in their digital transformation journey. I’m pleased to see the investment already delivering benefits for staff and supporting safer, more efficient care for patients.”

Dermot Ryan
NHS England’s Director of Digital Transformation