Bolton NHS Foundation Trust has become the first trust in Greater Manchester to implement district nurse referrals in its Sunrise™ Electronic Patient Record (EPR) system, powered by Altera Digital Health. It marks a major digital leap forward in integrating care across secondary and community services.

Clunky paper processes and fragmented communication have been replaced with a streamlined, digital workflow, enhancing patient safety and enabling teams to deliver faster, coordinated care across care settings.

Zoe Fitzsimmons, CXIO at Bolton NHS Foundation Trust, summed up the impact: “The district nurse referral within Sunrise has been transformative for the acute and district nursing teams. Now with one single source of truth, the teams no longer have to duplicate work or spend time investigating if a referral has been completed. This single process allows for one route to referral.”

With referral forms now fully embedded into the Electronic Patient Record (EPR), clinical teams can manage referrals directly within their existing workflow therefore there is no need to switch between systems. This streamlined approach has now not only boosted efficiency but has also enhanced user satisfaction. As referrals are created, key patient information is auto-populated from the EPR, saving staff time and reducing the risk of manual errors. It’s a smarter, faster way to handle referrals so clinicians can focus more on patient care and less on administration.

Take wound care as an example: when a patient has been assessed by the tissue viability team, detailed notes, treatment plans, and medication information are automatically pulled through into the referral. District nurses no longer need to chase down information; they’re fully briefed before their visit. As a result, they arrive at the patient’s home with the right dressings, supplies, and clear plan of care. It’s a seamless handover that reduces delays, enhances efficiency, and ensures patients receive safe, informed continuous care.

Patient safety was at the heart of the implementation. A significant portion of the rollout focused on aligning the referral process with complex transcribing and medication policies to ensure full compliance. The referral form was intelligently designed with mandatory fields, embedded guidance, real-time prompts, and conditional logic ensuring that no critical information is missed before submission. It’s a smart, safety-first approach that gives clinical teams confidence while reducing the risk of errors.

The results speak for themselves: reduced patient incidents, fewer inappropriate referrals, and stronger clinical oversight, all supported by a complete, traceable audit trail. The streamlined process also delivers measurable time savings across multiple stages of the referral pathway, enabling clinicians to focus more on care and less on admin. It’s a safer, more efficient system that drives real operational and clinical value.

“We ran time and motion studies and found nurses were spending approximately two hours a day ringing the wards to compile missing referral information so we could triage the referrals correctly, said Stacey Leigh, Digital Matron and Digital Clinical Safety Officer at Bolton NHS Foundation Trust.  “The teams would also run into issues when contacting the wards if members of staff who completed the form weren’t on shift and the information couldn’t be located.”

All community triage nurses and district nurse managers now have read access to the Sunrise EPR system, enabling them to review the patient’s clinical course, including the most recent admission and previous visits. Zoe Fitzsimmons added: “This will be enhanced further when the community teams go fully live on Sunrise later this year and can continue to document in the patient records as a seamless entry from acute to community.”

Referrals are now sent directly to a dedicated list within Sunrise, eliminating reliance on email and reducing the risk of missed or delayed communications. Each referral includes a direct link to the patient’s full EPR record, giving district nursing teams immediate access to all relevant information. They can quickly accept or decline the referral, while acute staff can track the referral status in real time, ensuring nothing falls through the cracks and everyone stays aligned throughout the patient’s care journey.

Rachael Fox, Executive Vice President, EMEA at Altera Digital Health, commented: “The progress at Bolton is a testament to what can be achieved with Altera’s highly configurable and flexible Sunrise EPR with a clear vision and a robust digital infrastructure. By embedding referrals directly into the EPR, Bolton has significantly improved communication and coordination between acute and community teams, enhancing both safety and efficiency.

What’s even more exciting is how this work is expanding access to comprehensive patient information within community care, enabling clinicians to have real-time visibility into treatment plans, clinical notes, and medications, empowering them to deliver informed, proactive care from the moment of discharge.

This is a powerful example of how our Sunrise platform enables continuous care across the entire healthcare setting, breaking down silos and creating a truly unified patient record. We’re proud to be supporting Bolton as it extends these capabilities further and unlocks even greater value across more community services and care pathways.”

Media Contact:
Jodie Cheetham (on behalf of Altera Digital Health)
Jodie@silver-buck.com
07967 136010

About Altera Digital Health

Altera Digital Health is a global healthcare IT leader. With more than 30 years of experience, we develop technology to bring next-level healthcare within reach. Our approach to solutions provides a fast, flexible and clinically driven roadmap towards digital maturity across integrated care systems.

With more than 2,700 hospitals in more than 15 countries, our solutions support healthcare providers, governments and military institutions around the world. By keeping the human user at the centre of our design methodology, we are supporting caregivers and helping patients meet and exceed their wellness goals. Together, with our clients, we’re driving a new era of healthcare. To learn more, visit uk.alterahealth.com.