Opinion: EPR Change is Hard – But People Make It Possible

I’ve spent a few years working on EPR projects and other complex NHS change initiatives. And if there’s one thing I’ve learned, it’s this: change isn’t really about technology. It’s about people. Human beings with opinions, feelings, habits, and histories. And that means change is personal, emotional, and, at times, unpredictable. 

This is the story of why managing the human side of EPR implementation is both the biggest challenge and the biggest opportunity we have. And it’s also why I believe Apira, an IQVIA Business, is uniquely placed to help NHS organisations navigate it successfully. 

What Change Really Means in EPR Projects 

Change management in an EPR context is the structured, collaborative approach to helping organisations like an NHS trust move from its current way of working to a new, improved future state. That might mean going from multiple disconnected systems (or even paper records) to one centralised integrated digital record accessible across departments. 

Sounds simple? On paper, perhaps. But behind every system there are thousands of people whose working lives will be directly affected by the implementation of a new EPR system. That’s where the complexity lies. 

EPR change means: 

• Clinicians adapting to new workflows. 

• Administrative staff learning unfamiliar systems. 

• Patients experiencing care in new ways. 

• Leaders making decisions based on data they’ve never had before. 

And every single one of those changes requires human adaptation. 

The Challenges No One Can Ignore 

When I first sit down with an NHS team at the start of an EPR journey, I often hear the same phrases: 

“If it isn’t broken, why fix it?” 
“We’ve tried this before and it didn’t work.” 
“This is just another initiative that will blow over.” 

Those comments aren’t signs of negativity, they are signs of lived experience. People remember past failed implementations, endless “change programmes” that delivered little, or systems that promised to save time but instead added extra work. 

From my perspective, the key challenges in EPR change are: 

1. Resistance to Change – This is universal. It’s not about obstinacy; it’s about self-preservation. Change brings uncertainty, and uncertainty can feel threatening. 
2. Lack of Stakeholder and Workforce Engagement – Too often, projects are “done to” staff instead of “done with” them. When people feel left out, they disengage. 
3. Poor Communication – In an absence of clear, consistent messaging, rumour and misinformation fill the gap. 
4. Lack of Adequate Resources – Change needs time, tools, and support. Without them, staff can feel set up to fail. 
5. Lack of Clear Objectives – If people don’t understand the “why” behind the change, they’re less likely to buy into it. 

Why Resistance Is a Gift in Disguise 

It might sound strange, but I see resistance as a positive sign. It means people care. If they didn’t, they wouldn’t bother raising concerns. 

The trick is to explore the source of that resistance. Is it fear of the unknown? Frustration from a lack of consultation? Worry about how the change will affect patient care? Each of these needs a different approach. 

In fact, some of my most successful project turnarounds have started with conversations that began in resistance. One nurse, for example, was strongly against a new EPR because she feared it would slow her down in emergencies. After listening to her, we involved her in testing and feedback and she became one of the biggest advocates, because she could see how the system would ultimately save time and improve safety. 

The Human-Centred Approach That Works 

Over the years, I’ve honed an approach that consistently helps NHS teams move from uncertainty to ownership. It’s based on four pillars: 

1. Bring People on the Journey

Change should never be a surprise. Involve staff early, explain why it’s necessary, and show them the tangible benefits, not just for the organisation, but for them. This builds trust and reduces fear. 

2. Listen Deeply and Often

This is more than holding a token focus group. It’s about walking the wards, sitting in the offices, shadowing roles, and really understanding the daily realities of the people affected. The insights you gain here are gold. 

3. Communicate Clearly and Consistently

Mixed messages are the enemy of change. At Apira, we create tailored communication strategies that adapt to the audience, whether that’s a busy consultant who needs a one-page brief or an admin team who prefers step-by-step video guides. 

4. Equip People for Success

Training isn’t “one-size-fits-all.” People learn differently. Some prefer classroom settings, others thrive on hands-on practice. We design flexible learning approaches that give every individual the confidence to succeed. 

Why Apira’s Approach Works 

I’ve seen the difference between a purely technical EPR rollout and one that puts people first. The former can meet deadlines but still fail to deliver long-term benefits. The latter, our approach at Apira, ensures that adoption is embedded, sustained, and embraced. 

We do this by: 

• Building strong and lasting relationships with stakeholders at all levels. 

• Being transparent about challenges and solutions. 

• Keeping a positive mindset, even when roadblocks appear. 

• Making sure every stakeholder understands project objectives and their personal role in achieving them. 

And because we’ve worked with countless NHS organisations, we know the patterns – the moments when morale dips, when communication needs a boost, and when small adjustments can make the difference between pushback and progress. 

The Payoff of Getting It Right 

When EPR change is managed well, the benefits ripple across the organisation: 

• Staff feel valued and included. 

• Patients experience safer, more efficient care. 

• Leaders have better data for decision-making. 

• The organisation becomes more adaptable and resilient. 

And perhaps most importantly, the culture shifts. Change becomes something people believe they can handle and maybe even welcome. 

Let’s Talk About Your Journey 

EPR implementation will always be challenging. But with the right approach, it’s not just achievable, it can be transformative. The key is to remember that technology is just the tool. People are the power. 

At Apira, we specialise in helping NHS organisations put people at the heart of change. We listen. We engage. We support. And we stick with you, not just until go-live, but until the change is truly embedded. If your organisation is facing an EPR journey and you’re concerned about the human side of change, let’s start the conversation. Because we know that with the right support, your people can not only adapt but they can thrive. 

Please do get in touch to discuss your change management requirements and how Apira could help you along your digital journey – david.corbett@apira.co.uk  

About the author –

Lou works with Apira as a Consultant and with 15 years of NHS experience in various administration and management roles, Lou brings a deep understanding of healthcare operations and a strong focus on quality improvement. Her previous secondment as an EPR Change Agent within a Trust Digital Department sparked her passion for large-scale project work and laid the foundation for her current role in digital transformation.

Lou has led business change management throughout the full project lifecycle—reviewing AS-IS workflows, designing TO-BE processes, and ensuring alignment with service needs and best practice. She has worked closely with clinical and non-clinical stakeholders to build engagement, drive decision-making, and support successful implementations.

Her hands-on experience includes delivering training, conducting readiness checks, facilitating workflow walkthroughs, and providing comprehensive go-live support. Lou is passionate about making a meaningful difference for both patients and the healthcare workforce, and her collaborative, thoughtful approach is a valuable asset to every project she supports.