One year after implementing its electronic prescribing and medicines administration system, Julia Scott, Pharmacist and CxIO at Dartford and Gravesham NHS Trust Dartford and Gravesham NHS Trust, reflects on a transformative journey that has redefined medication safety, empowered clinicians, and laid the groundwork for a new era of digital medicines optimisation.

In the ever-evolving landscape of healthcare, digitalisation is no longer a distant goal, it’s a burning platform. At Dartford and Gravesham NHS Trust, the implementation of our electronic prescribing and medicines administration (ePMA) system, Better Meds, was not just a technological shift; it was a cultural transformation, taking that burning platform and turning it into burning ambition. It placed patient safety, staff experience, and clinical effectiveness at the heart of digital transformation.

By pioneering this system, the Trust has set a powerful example of what can be achieved when thoughtfully designed technology meets rigorous but flexible execution. One year after the initial rollout, we reflect on our journey and on how ePMA sets the bar for safer, better medicines optimisation.

For frontline clinicians, the stakes couldn’t be higher. Medication errors, inefficiencies in prescribing, manual transfer of safety-critical information, and fragmented communication have long plagued healthcare systems, often with devastating consequences.

With ePMA, however, the playing field has changed. As our experience shows, electronic systems are not just about reducing the paper, they’re about reimagining how care is delivered, ensuring that every decision is informed by data, transparent, and clinically sound. Our experience was that staff were eager to adopt the system from the beginning, with the question “Why haven’t we done it already?” resonating throughout the course of the project.

Empowering clinicians and patients

One of the most compelling outcomes of ePMA adoption is its ability to empower clinicians. By offering a streamlined, intuitive interface, Better Meds reduces administrative burdens and frees up time for what truly matters: patient care. Clinicians can quickly access comprehensive medication histories, make informed prescribing decisions with in-workflow decision support, easily access linked guidelines and resources, review medication administration records, and collaborate more effectively across teams.

For patients, this translates into safer, more personalised care. Medication errors are a persistent and often intractable issue in healthcare. But they can be significantly reduced when prescribing is guided by real-time intuitive alerts within the system, with pre-configured order sets that support evidence-based prescribing practice, and with genuinely strong barriers to key types of error through a system design that allows hard stops. Patients benefit not only from increased safety but also from the confidence that their care is guided by the most accurate, up-to-date information available.

Challenges and successes of implementation

Looking back, our journey to ePMA success came with its share of challenges. It is in how Trust staff rose to these challenges that our success was forged. As our team found early on, effective implementation requires a strong commitment to address the human side of change management as a priority. This goes beyond stakeholder engagement, training, and communication, and reaches into the need to build psychological safety, to embrace the learning that comes with failure by building in tools to allow us to fail safely, and to focus on building momentum and belief for change.

The Trust’s approach underscores the importance not just of stakeholder engagement, but of actively bringing as many stakeholders as possible into the team, so that they are delivering the transformation themselves.

Training did play a pivotal role in our success; eLearning modules developed by our digital clinical team ensured clinicians reached a minimum level of competence before they were granted access. At-your-elbow support by our #DigitalHeroes turned competence into confidence, helping staff understand the full benefits of the system. This clinically-led, in-house support model fostered a sense of ownership and enthusiasm, as well as building our capacity for future digital change.

Adaptability was another key lesson. No two hospitals are alike, and while ePMA is a great tool for clinical standardisation through guidelines, it must be tailored to fit the unique workflows and priorities of each organisation. For us, this meant refining processes, addressing feedback, and continuously improving the system post-implementation.

A blueprint for the future

The success of ePMA at our Trust can offer a blueprint for healthcare organisations across the UK. It shows that digital transformation is not just a technical endeavour but a deeply human one, requiring empathy, collaboration, and a clear vision for better patient outcomes. As the NHS continues its shift toward greater digitalisation, these lessons from our Trust resonate loudly. ePMA is more than just a tool; it’s a step change, a catalyst for transformation, setting the bar for what’s possible in modern healthcare.

To others embarking on this journey, I advise that you ensure patient safety is your project True North, the place where you do not tolerate compromise. Recognise that successful implementation requires as much attention, if not more, to human factors and an understanding of our shared human experience, as it does to the technical elements. ePMA is not simply a technological upgrade, it’s an opportunity to transform medicines optimisation across the entire system.

My final message would be to remain curious. At Dartford and Gravesham, ePMA year one was about change, but year two is going to be about impact. Go-live really is just the beginning; optimisation is where it gets really interesting.

You will discover new types of errors that need to be safeguarded against. Your clinical teams will find innovative workarounds that you couldn’t have imagined during your planning. You will find zealots and laggards – embrace them both for what they can teach you about the system. We are just scratching the surface of how we can now start to use the detailed prescribing data we now have at our fingertips to further drive quality. Now is not the time to get complacent, or to relax. Keep the improvement flywheel moving, putting in the continuous work to build on the momentum your go-live created.

Finally, I’ve been asked whether, with the benefit of a year’s hindsight, I would have done anything differently. My answer to this is “Yes, I would have gone even bigger!”.