One record. Three networks. 730,000 patients.

Lancashire and South Cumbria NHS Foundation Trust serves a population of around 1.4 million people across three distinct clinical networks: mental health, community and wellbeing, and children and young people.

In June 2019, The Trust migrated the majority of its legacy patient administration system (PAS) records from its 53 clinical services across 85 sites, over to Access Rio. The complex migration included moving 730,000 demographics, 99,000 referrals and approximately 10,500 waiting list comments. Despite the complex and daunting process, thanks to our support, the migration ran smoothly.

When looking to replace its existing Electronic Patient Record (EPR), Lancashire and South Cumbria NHS Foundation Trust had ambitions to improve its quality of care, clinical safety, patient experience and productivity.

For a patient moving between those networks - a young person transitioning from CAMHS to adult mental health services, or a community patient with co-occurring physical and mental health needs - their record did not follow them. Clinicians were working from fragmented information, duplicating data entry across disconnected systems, and making decisions without a complete picture of the patient in front of them.

The Trust's legacy patient administration system (PAS) had reached the end of its useful life. Records were siloed. Referral data was inconsistent. Waiting list information was held in formats that could not be shared across services. The Trust needed a single, unified Electronic Patient Record that could serve every clinical team, connect to the wider health and care system across Lancashire and South Cumbria, and support its ambitions as a Global Digital Exemplar Fast Follower - a programme designed to accelerate digital maturity across NHS mental health and community trusts.

The question was not whether to replace the legacy system. It was how to do so without disrupting care for hundreds of thousands of patients across dozens of sites.

The Trust selected Access Rio - the UK's leading EPR system in the mental health and community health sector - following a competitive procurement process. Implementation began in 2017, with a phased rollout designed to bring each clinical network onto the platform without service disruption.

The phased approach allowed clinical teams to transition at a pace that worked for their services, with Access providing implementation support, training, and technical guidance throughout. In July 2018, all LSCFT services moved their administrative records to Rio. By June 2019, the Trust was ready for the most complex phase: migrating the bulk of its legacy PAS records across all 53 clinical services and 85 sites.

The migration involved:

• 730,000 patient demographics transferred from the legacy system
• 99,000 referrals migrated without loss of data integrity
• 10,500 waiting list comments preserved and accessible in the new system

The scale of this migration - across three clinical networks, dozens of sites, and years of accumulated patient data - required meticulous planning, close collaboration between the Trust's digital team and Access, and a shared commitment to getting it right for patients. The migration completed without disruption to clinical services.

Replacing the legacy PAS was the foundation. The next step was connecting Rio to the broader health and care ecosystem across Lancashire and South Cumbria.

The Trust uses Rio to feed into the Lancashire Person Record Exchange Service (LPRES) - a Shared Care Record that connects health and social care organisations across the region. Through LPRES, clinicians at GP practices, ambulance services, acute hospitals, and A&E departments can access key patient information from the Trust's records at the point of care.

LPRES uses the Medical Interoperability Gateway (MIG) to send clinical documents to more than 300 GP practices across Lancashire and South Cumbria. A patient presenting at A&E, or a GP reviewing a patient with a complex mental health history, can now access up-to-date information from the Trust's records — reducing the risk of decisions being made without the full clinical picture.

This level of interoperability reflects the direction of NHS digital strategy. NHS England's plan for digital health and care sets out the expectation that all constituent organisations of an Integrated Care System (ICS) should be connected to an integrated health and care record — giving clinicians access to a complete view of a person's information across settings. Lancashire and South Cumbria's work with Rio and LPRES puts the Trust at the leading edge of that ambition.

The goal throughout has been straightforward: one patient, one record, regardless of which service they are receiving care from.

As the Rio deployment reaches completion across all three clinical networks, a clinician creating a podiatry referral and a clinician managing a mental health care plan are working from the same patient record. Duplication is eliminated. The risk of a clinician acting on incomplete or outdated information is reduced. And for patients whose needs span more than one service - which, for a trust serving 1.4 million people across mental health, community, and children's services, is a significant proportion - their care is better coordinated.

The Trust's digital priorities for 2026/27 build on this foundation, focusing on using data to improve community health outcomes, supporting people to manage their health at home, and using AI-driven administrative processes to free up staff time for patient-facing tasks. Rio provides the data infrastructure that makes those ambitions achievable.

Lancashire and South Cumbria's journey illustrates what is possible when a complex, multi-network NHS trust commits to a structured, phased EPR implementation - and chooses a partner with the experience to deliver it at scale.

The challenges the Trust faced are not unique. NHS mental health and community trusts are operating under sustained pressure, with a mental health waiting list of 1.9 million people and increasing demand from an ageing, multimorbid population. In that context, clinicians need systems that give them accurate, complete information at the point of care - not systems that require them to search across disconnected records or re-enter data they have already captured elsewhere.

The ability to access up-to-date patient medical records at any time increases safety, improves outcomes, and delivers productivity benefits compared with paper records. Data systems that are interoperable between providers enable the different parts of the NHS and social care to work in a joined-up way. Rio, and the LPRES integration it supports, delivers both.

For LSCFT, they managed to reduce duplication of patient information, improving efficiencies across Lancashire and South Cumbria NHS Foundation Trust.

By onboarding Access Rio, they achieved the digitisation of records at the Trust’s Learning Disability Services and other early adopter services. This also empowered clinicians with access to up-to-date patient information at the point of care.

The next phase of the rollout is to enable mental health services with full clinical functionality. Lancashire and South Cumbria NHS Foundation Trust will be working with us to achieve greater integration with other systems with Rio at its core.