Andy Hardy: ‘It’s unbelievable we don’t all have sight of patient records

During his 15 years as chief executive of University Hospitals Coventry and Warwickshire (UHCW), Andy Hardy has overseen a major transformation programme, including the implementation of the trust’s electronic patient record (EPR).

Hardy has spent his entire 30-year career within the NHS, starting as a trainee accountant before working his way up to chief financial officer and eventually chief executive.

Ahead of Digital Health Summer Schools 2025, he sat down with Digital Health News to discuss UHCW’s digital aspirations and explain why the NHS needs to move forward with a single patient record.

In a recent NHS provider survey 81% of trust leaders said that there is insufficient funding for digital transformation. Is that your experience?

It’s always easy to say there’s not enough funding around to do transformation, whether that be digital or otherwise. It’s how you prioritise what you have got.

We’ve got a budget of £180bn, but transformation can come down the list when you’ve got the pressures of today.

There’s two parts to digital transformation: the tech and the people to make the change with the tech. It’s for organisations to invest in the right people.

I think there are specific issues where we do need central funding, for example, large EPR systems.

Also we could do more on national procurement of technology so that we’re not always individual organisations going through procurement to buy the same thing and not getting the best price.

We could use economy of scale for procurement provided by the NHS, and also have proven technology which the NHS could use, so that would save money.

What are UHCW’s digital aspirations?

For a long time, I’ve talked about UHCW as being data-led, operationally delivered. I’m always looking to see how we can utilise digital technologies and data to give better patient care.

There are so many products on the market now that we need to think about what we can push ahead with. The technology is out there which can make massive difference in the health service. It’s just how we get to utilise and spread it.

We’re still only the beginning of the journey of AI in healthcare and I’m excited about that

In my organisation, we’re only just at the beginning of the pathway of using ambient script technology, and I think that it will lead to massive productivity and quality change. I see particular advantages in the outpatient setting, but also in theatres.

Of course, there’s also the potential use of tools such as Copilot to minute team meetings. It’s not just about clinical areas.

We’re looking to choose preferred providers [for ambient AI] in the next couple of months, to roll out in autumn.

I also want to start thinking about how we can get to an autonomous coding position, not just for the financial benefits associated, but for deeper understanding of  our patients’ conditions and how we’re treating them.

We’re still only the beginning of the journey of AI in healthcare and I’m excited about that.

There was an eight-month delay to your EPR going live. What challenges did you face with implementation?

We went live with Oracle Cerner Millennium on 15 June 2024, so we’ve just celebrated its first birthday. Originally we were looking at going live in October 2023 but we moved that back.

Fundamentally we didn’t feel we were ready as an organisation in terms of the correct levels of training, understanding what the system meant and pathway design, so we made the decision to wait and get it right.

Of course, we’ve still got some teething problems 12 months in, which are inevitable. Unsurprisingly there were some productivity challenges in the early days. As people are getting used to a new system it takes them longer to do things. Also there were some data quality issues.

We are though already seeing benefits of the EPR. Many clinicians talk about the advantages of having all information in one place and having one single source of truth, so they can make better, more informed clinical decisions and start to understand the patient population in a much better way.

UHCW ran a pilot to see how using AI for ‘process mining’ could improve patient care. Have you extended the programme?

We’re working alongside our partner, Celonis, and looking at three or four different areas at the moment, theatres being one of them.

We’re also looking at further work around outpatients, and then we’re moving on to cancer pathways and urgent and emergency care pathways. We’ll have early results for theatres by the end of June, and we’re looking to make changes by September.

Process mining identifies variation in process. Whenever we can standardise, we reduce waste, reduce time waiting for patients, reduce wasted time flow for clinicians.

We were an early adopter of the federated data platform (FDP). It’s going well, and we’re working with the national team to look at some of their early use cases, including potentially the use of data mining.

We want to see how process mining can work as a tool for the FDP.

UCAW expanded its virtual ward offering to respiratory conditions in 2022. Are you still expanding your virtual wards?

We’re absolutely looking to expand virtual wards. In July last year we integrated community services into our trust, and that aids and adds to our ability to do more on a virtual basis and get the right technology in place.

We constantly review what we can do through a virtual ward and what we can do in the community that doesn’t need to be in a hospital.

What are you hoping to see in the NHS 10 year health plan around digital?

There should be a clear recognition of the volume of transformation that could occur in the health service by better use of technology, such as standardisation of technology and the use of data in the world of AI.

As we move towards cloud-based technology we need connectivity between all services

We need to think about how that is funded: what is capital and what is revenue? Can we do something about that with the Treasury?

As we move towards cloud-based technology we need connectivity between all services. In 2025 it’s unbelievable to most people that we haven’t all got sight of everybody’s patient records from all different partners. So how do we move forward on that?

I’d like to see how we can get to more mature approaches to sharing our data for life sciences and research to better understand the health of the population.

What is your view on the plans for a single patient record?

I don’t understand why we haven’t already got one. The technology is there.

We get stuck behind things like GDPR with organisations thinking the data belongs to them. No, it’s doesn’t. It’s the data of the population we serve, so let’s use it better to serve them better.

You can’t constantly be looking backwards. People hark back to the NHS National Programme for IT. Things didn’t work then, but the world has moved on.

We need to move with it and put the ‘N’ back in the National Health Service.

Can you give us a taster of what you’ll speak about at Summer Schools?

I’ll be giving a chief executive’s view on the potential for digital and data to change the health service.

Hardy will be speaking at Digital Health’s Summer Schools 2025, 17-18 July at the University of Warwick. The event is supported by Networks sponsors Alcidion, AWS, Altera, Bridgehead, CereCore, Dell Technologies + AMD, Imprivata, Intersystems, Microsoft and Salesforce.