Most widely used care management systems in the UK

Digital health infrastructure sits at the centre of every major NHS reform agenda, and for healthcare decision makers, choosing the right care management system is one of the most consequential technology decisions an organisation can make. Whether the context is a GP practice navigating primary care network integration, an NHS trust modernising its inpatient workflows, or a social care provider responding to new Care Quality Commission inspection frameworks, the system underpinning clinical documentation, triage, referrals, and patient records shapes both the quality of care and the administrative load placed on clinicians. With the UK medical record system market valued at USD 2,333.7 million in 2025 and forecast to reach USD 3,257.7 million by 2033, the landscape is large, fragmented, and evolving. This guide maps the most widely used care management systems across UK healthcare settings and provides a structured framework for evaluating them.

What is a care management system, and why does it matter for UK healthcare?

The term "care management system" is used broadly, but in UK healthcare it typically refers to software that coordinates and documents patient care across one or more settings. This distinguishes it from a pure medical record system, which primarily stores clinical data. A care management system integrates care planning, scheduling, clinical documentation, referral management, and in many cases rostering and compliance monitoring into a single platform.

For NHS organisations operating under Integrated Care System (ICS) structures, the choice of care management system has strategic implications beyond individual workflow efficiency. Systems must interoperate across primary, secondary, and social care; support shared care records; and align with NHS England's digital transformation expectations. For independent and private healthcare providers, procurement decisions are shaped by Care Quality Commission regulatory requirements, data security and privacy obligations under the General Data Protection Regulation (GDPR), and the need to demonstrate clinical governance through structured, auditable records.

How the UK care management system market is structured

The UK market does not operate as a single procurement environment. It is segmented by care setting, commissioning body, and regulatory context, and this fragmentation directly determines which systems dominate where.

In primary care, GP practices and primary care networks typically procure clinical systems through NHS England-approved frameworks, with a small number of vendors holding the vast majority of market share. In secondary and acute care, NHS trusts procure Electronic Patient Record (EPR) systems through NHS Shared Business Services or Crown Commercial Service frameworks, often following lengthy competitive tender processes. In community, mental health, and social care, procurement is more varied, involving local authorities, Integrated Care Boards (ICBs), and independent providers operating under different regulatory regimes.

Web and cloud-based medical record systems represented 86.78 per cent of the UK market by revenue share in 2025, reflecting a broad shift away from on-premise legacy systems. The pace of this transition varies considerably by setting. NHS hospital trusts have historically been slower to modernise than primary care, though the UK government set a target for 90 per cent of NHS trusts to have an EPR meeting defined digital maturity standards by March 2023, with full coverage intended by 2025.

The most widely used care management systems in UK primary care

Primary care in England operates with a notably concentrated market. Three platforms account for the overwhelming majority of GP practice deployments.

EMIS Web is the most widely used GP clinical system in England, with market share estimates placing it at approximately 55 per cent of GP practices. It supports a broad range of clinician workflows including clinical documentation, SNOMED-coded clinical coding (SNOMED CT is the standardised clinical terminology used across NHS systems), referrals, prescribing, and population health management. Its dominance means it is frequently the integration anchor point for third-party tools, including AI assistants and remote consultation platforms. Research published in the Journal of Medical Internet Research has demonstrated how medical record system interface design in EMIS and comparable systems directly influences clinical safety, including prescribing behaviour, a finding with direct implications for procurement decisions.

SystmOne, developed by TPP, holds the second-largest share of the primary care market and is particularly prevalent in practices across the North of England. It is also deployed in community nursing, urgent care, and some secondary care settings, giving it a cross-setting footprint that EMIS Web does not replicate to the same degree. SystmOne's shared record architecture means that patient data is accessible across all SystmOne-using organisations within a region, which has both interoperability advantages and information governance considerations.

Vision, historically the third major primary care platform, was acquired by OneAdvanced in August 2025, a development that raises questions about the product's long-term investment trajectory and support model. Vision's market share has been declining relative to EMIS Web and SystmOne, and some practices have used contract renewal points to migrate.

Microtest Evolution serves a smaller segment of the primary care market, predominantly in specific regions, and is less commonly encountered in procurement evaluations at scale.

A co-design study published in the Journal of Medical Internet Research found that clinical decision support systems must be integrated within existing medical record system prescribing workflows rather than accessed through standalone portals to be adopted by primary care clinicians. This finding is relevant for any organisation evaluating how add-on tools will function within EMIS Web, SystmOne, or Vision environments.

Leading care management systems in UK secondary and acute care

The secondary and acute care market has undergone significant consolidation over the past five years, driven by NHS England's EPR programme and the availability of targeted capital funding for digital transformation.

Epic has become the most prominent EPR vendor in large NHS teaching hospitals and integrated academic health science networks. Its deployments at University College London Hospitals, Cambridge University Hospitals, and other flagship trusts have established it as the reference point for high-acuity, high-complexity inpatient care environments. Epic's breadth of functionality, covering inpatient care, ward round documentation, discharge summaries, outpatient scheduling, and clinical coding, means it is often positioned as a full-stack replacement for legacy systems rather than a point solution.

Oracle Health (formerly Cerner) has a substantial installed base across NHS trusts. Oracle Health has been deployed at London North West University Healthcare NHS Trust and The Hillingdon Hospitals NHS Foundation Trust, among others. Oracle Health's Millennium platform covers similar functional territory to Epic and is frequently encountered in competitive procurements.

System C (Medway) serves a significant portion of mid-tier NHS trusts and is particularly prevalent in district general hospitals. Its Patient Administration System (PAS) functionality is widely used, and System C has invested in EPR capabilities that allow trusts to build on existing Medway deployments rather than undertaking full system replacement.

IMS MAXIMS supplies both open-source and commercial EPR and PAS solutions to NHS and private providers, with deployments including Taunton & Somerset and Blackpool Teaching Hospitals. Its open-source approach is attractive to trusts seeking to avoid long-term vendor lock-in.

As of late 2023, approximately 90 per cent of NHS hospital trusts had adopted EPR systems, with the ambition of full coverage by March 2025. In practice, adoption levels and system maturity vary considerably, and many trusts operate hybrid environments where a modern EPR sits alongside legacy departmental systems for pathology, radiology, or pharmacy.

Care management systems in mental health, community, and social care settings

Outside acute settings, the care management system landscape is more varied and, in some respects, less mature in its digital development.

RiO, originally developed by Servelec and now under Civica ownership, is one of the most widely deployed systems in NHS mental health trusts and community health services. It handles the documentation-heavy, longitudinal care records characteristic of mental health services, including care plans, risk assessments, and multi-disciplinary team notes. Its triage workflow functionality is relevant in the context of the substantial volume of referrals processed by NHS mental health services, each requiring clinician triage using medical record system data, a volume that creates significant pressure on both system performance and clinician cognitive load.

Liquid Logic, now part of the Access Group, is widely used in local authority adult social care and children's services. It is designed for case management workflows that differ substantially from clinical documentation in NHS settings, incorporating statutory assessment frameworks, safeguarding workflows, and multi-agency information sharing.

In the residential and domiciliary care sector, Person Centred Software (PCS) claims to be the most widely used digital care management tool in the UK, deployed in over 8,000 care settings, according to the company. Its mCare mobile application lets care staff record observations, fluid and nutrition monitoring, and body maps at the point of care rather than retrospectively at a desk, a design principle that directly addresses documentation burden in care home environments.

Access Care Management, part of the Access Group, claims over 14,000 registered care locations across the UK and integrates care planning, rostering, compliance monitoring, and real-time care delivery in a single platform. It is positioned across home care, care homes, supported living, and complex care settings.

Nourish is the other widely recognised platform in the residential care segment, with a particular emphasis on person-centred care planning and mobile-first documentation.

Research examining the implementation of Electronic Palliative Care Coordination Systems (EPaCCS) across multiple UK care settings identified that inconsistent use and poor interoperability across care settings remain the primary barriers to effective digital care coordination. The findings are broadly applicable to care management system adoption across community and social care, where multi-agency information sharing is structurally complex.

Key features healthcare decision makers should evaluate

When comparing care management systems across settings, decision makers should assess the following functional dimensions:

• Structured notes and data: The degree to which the system enforces or encourages structured clinical documentation using standardised terminologies such as SNOMED CT or ICD-10 (the International Classification of Diseases, used for coding diagnoses and procedures), rather than free text alone. Structured data supports population health analytics, audit, and interoperability.

• Real-time transcription and ambient voice technology: Whether the system natively supports or integrates with speech-to-text and ambient voice tools that reduce the time clinicians spend typing during or after consultations.

• Clinical decision support: The availability of in-workflow alerts, protocol prompts, and AI-assisted recommendations, and whether these are embedded in the prescribing or documentation workflow rather than accessed separately. Evidence suggests that clinical decision support must appear within the active clinical workflow to be used consistently.

• Patient summaries: The ability to generate concise, structured patient summaries that can be shared across care settings, including discharge summaries and referral letters.

• Interoperability standards: Compliance with HL7 FHIR (Health Level 7 Fast Healthcare Interoperability Resources) application programming interfaces (APIs), which are increasingly required for NHS data sharing frameworks and shared care record programmes.

• Data security and privacy: ISO 27001 certification (the international standard for information security management), NHS Data Security and Protection Toolkit compliance, and GDPR-aligned data residency arrangements, particularly relevant for cloud-hosted systems processing sensitive clinical data.

Feature richness does not guarantee clinical adoption. Research comparing medical record systems in English primary care found that design choices within the system interface, not just the presence of a feature, significantly influence clinical behaviour and safety outcomes. Usability testing with representative clinical users should be a standard component of any procurement evaluation.

The role of AI integration in modern care management systems

AI medical assistants and ambient voice technology are increasingly being layered onto existing care management systems, with the primary goal of reducing documentation burden and cognitive load for clinicians. The integration model varies: some vendors are building AI capabilities natively into their platforms, while others are opening their systems to third-party AI tools via APIs.

Epic has invested significantly in AI-native features, including ambient documentation tools and predictive analytics embedded in the clinical workflow. Oracle Health has partnered with external AI vendors to extend its capabilities. In primary care, platforms such as EMIS Web and SystmOne have opened API access to third-party AI assistants, letting ambient voice tools write directly into the clinical record.

In mental health services, the application of large language models (LLMs, a class of AI that generates and processes text) to medical record system triage workflows has been the subject of direct NHS research. A study published in Artificial Intelligence in Medicine demonstrated that LLM-based triage models can deliver recommendations consistent with existing clinical practice when implemented on a single graphics processing unit (GPU), making them practical for resource-limited NHS environments where on-premise deployment is necessary to maintain clinical data governance.

AI integration is not uniform across the market. Many mid-tier and community care systems remain at an early stage of AI adoption, and the gap between the most AI-capable platforms and legacy systems is widening. For decision makers, this creates a risk of selecting a system that is functionally adequate today but structurally unable to support AI-assisted workflows within a two-to-three year horizon.

Interoperability and integration: the critical procurement challenge

Connecting care management systems across primary, secondary, and social care is one of the most persistent problems in UK health and care digitalisation. Most NHS patients receive care from multiple organisations using different systems, and the absence of seamless data exchange creates both clinical risk and administrative duplication.

NHS England's shared care record programme, delivered through ICS infrastructure, is intended to address this by creating a unified view of patient data across organisational boundaries. Progress has been uneven. Breakdowns in implementation at individual, organisational, and technical levels lead to inconsistent use and reduced confidence in shared records, particularly where access permissions and data quality vary across contributing systems.

The adoption of HL7 FHIR as the standard API architecture for NHS data exchange is a positive structural development, but many legacy systems, particularly older PAS and departmental systems in acute trusts, do not natively support FHIR and require middleware or integration engines to participate in shared record architectures. This adds cost and complexity to procurement decisions, particularly for trusts operating hybrid environments.

Inconsistent clinical coding practices also undermine interoperability. Where one system records a diagnosis using a SNOMED CT code and another uses free text or a local code, automated data exchange produces incomplete or unreliable records. Addressing this requires both system configuration and clinician training investment that is frequently underestimated in implementation planning.

Procurement considerations for NHS and independent healthcare providers

Healthcare decision makers evaluating care management systems should structure their assessment around the following criteria:

• Total cost of ownership: Licensing, implementation, training, integration, and ongoing support costs over a five-to-ten year horizon. Large EPR deployments in particular carry significant hidden costs in data migration, interface development, and change management.

• Implementation timelines: NHS EPR programmes have a history of delays. Realistic timelines, phased implementation options, and vendor track records on delivery should be scrutinised during due diligence.

• Clinical workflow fit: Systems should be evaluated against the specific workflows of the clinical teams who will use them, not against generic feature lists. Usability testing with representative users is essential.

• Vendor support and stability: The acquisition of Vision by OneAdvanced in 2025 illustrates how ownership changes can affect product roadmaps and support quality. Vendor financial stability and strategic commitment to the NHS market are legitimate evaluation criteria.

• Alignment with NHS England frameworks: NHS England's What Good Looks Like (WGLL) framework defines the expected digital maturity for NHS providers. Procurement decisions should be assessed against WGLL standards to ensure alignment with national expectations and to support Digital Maturity Assessment submissions.

• CQC compliance: For social care providers, the CQC's Single Assessment Framework and new ICB mandates for data sharing are driving adoption of platforms that can demonstrate compliance through structured, auditable digital records.

What the UK care management system landscape will look like by 2027

Several structural forces are likely to reshape the UK care management system market over the next two to three years.

Consolidation is continuing across all segments. The Access Group's acquisitions in social care, Oracle Health's NHS expansion, and the competitive pressure on smaller vendors suggest that the number of viable platforms in each segment will contract. For decision makers, this increases the importance of evaluating vendor stability alongside product capability.

AI-native platforms are beginning to differentiate from AI-enabled incumbents. Systems that have embedded ambient voice technology, clinical decision support, and predictive analytics into their core architecture, rather than adding them via third-party integrations, are likely to hold a structural advantage as NHS organisations seek to reduce documentation burden at scale. The evidence base for AI-assisted triage and documentation in NHS settings is growing, and procurement frameworks are beginning to reflect this.

ICS-driven procurement is becoming more influential. As Integrated Care Boards mature, there is growing pressure toward ICS-wide system standardisation, particularly for shared care records and population health management. This is likely to favour vendors with cross-setting capability and strong interoperability credentials over those with deep but narrow functionality in a single care segment.

Interoperability mandates through FHIR API requirements and shared care record standards will increasingly function as de facto procurement filters, excluding systems that cannot demonstrate standards-compliant data exchange. Decision makers procuring now should treat FHIR compliance not as a future consideration but as a current baseline requirement.

The direction of travel is towards fewer, more capable platforms with AI integration, standards-based interoperability, and cross-setting functionality. The procurement decisions made by NHS trusts, ICBs, and independent providers over the next 18 months will determine which organisations are positioned to benefit from that trajectory, and which will face costly system replacement cycles within the decade.

Frequently asked questions

▶ What is a care management system and how does it differ from a medical record system?

A care management system coordinates and documents patient care across one or more settings. It goes beyond storing clinical data by integrating care planning, scheduling, clinical documentation, referral management, and in many cases rostering and compliance monitoring into a single platform. A medical record system, by contrast, primarily stores clinical data without necessarily connecting those wider workflows.

▶ Which care management systems are most widely used in UK primary care?

Three platforms account for the overwhelming majority of GP practice deployments in England. EMIS Web holds approximately 55 per cent of the market and is the most widely used GP clinical system in England. SystmOne, developed by TPP, holds the second-largest share and is particularly prevalent in the North of England. Vision, historically the third major platform, was acquired by OneAdvanced in August 2025, raising questions about its long-term investment trajectory. Microtest Evolution serves a smaller regional segment.

▶ Which Electronic Patient Record systems are most commonly used in NHS hospitals?

Epic has become the most prominent Electronic Patient Record vendor in large NHS teaching hospitals, with deployments at University College London Hospitals and Cambridge University Hospitals among others. Oracle Health (formerly Cerner) has a substantial installed base across NHS trusts, including London North West University Healthcare NHS Trust. System C (Medway) is widely used in district general hospitals, and IMS MAXIMS supplies both open-source and commercial solutions to NHS and private providers. As of late 2023, approximately 90 per cent of NHS hospital trusts had adopted Electronic Patient Record systems.

▶ What care management systems are used in mental health, community, and social care settings?

RiO, now under Civica ownership, is one of the most widely deployed systems in NHS mental health trusts and community health services. In local authority adult social care and children's services, Liquid Logic (part of the Access Group) is widely used. In residential and domiciliary care, Person Centred Software claims deployment across over 8,000 care settings in the UK, while Access Care Management reports over 14,000 registered care locations. Nourish is another widely recognised platform in the residential care segment, with a focus on mobile-first documentation.

▶ What features should healthcare decision makers evaluate when comparing care management systems?

Key dimensions to assess include: structured notes and data using standardised terminologies such as SNOMED CT or ICD-10; support for real-time transcription and ambient voice technology; clinical decision support embedded within active clinical workflows rather than accessed separately; the ability to generate structured patient summaries and discharge summaries; compliance with HL7 FHIR (Health Level 7 Fast Healthcare Interoperability Resources) application programming interfaces for NHS data sharing; and data security credentials including ISO 27001 certification and NHS Data Security and Protection Toolkit compliance. Evidence suggests that interface design, not just feature availability, significantly influences clinical behaviour and safety outcomes.

▶ How is AI being integrated into care management systems in the NHS?

AI medical assistants and ambient voice technology are increasingly being layered onto existing care management systems, primarily to reduce documentation burden and cognitive load for clinicians. Epic has embedded ambient documentation tools and predictive analytics natively into its clinical workflow. Oracle Health has partnered with external AI vendors. In primary care, EMIS Web and SystmOne have opened API access to third-party AI assistants, allowing ambient voice tools to write directly into the clinical record. Research published in Artificial Intelligence in Medicine found that large language model-based triage models can deliver recommendations consistent with existing clinical practice when deployed on a single graphics processing unit, making them practical for resource-limited NHS environments.

▶ Why is interoperability such a persistent challenge for UK care management systems?

Most NHS patients receive care from multiple organisations using different systems, and the absence of seamless data exchange creates both clinical risk and administrative duplication. Many legacy Patient Administration Systems and departmental systems in acute trusts do not natively support HL7 FHIR and require middleware or integration engines to participate in shared record architectures. Inconsistent clinical coding practices also undermine interoperability: where one system records a diagnosis using a SNOMED CT code and another uses free text, automated data exchange produces incomplete or unreliable records. Research examining Electronic Palliative Care Coordination Systems found that inconsistent use and poor interoperability across care settings remain the primary barriers to effective digital care coordination.

▶ What procurement criteria should NHS and independent healthcare providers apply when selecting a care management system?

Decision makers should assess total cost of ownership over a five-to-ten year horizon, including licensing, implementation, training, integration, and ongoing support. Implementation timelines and vendor track records on delivery warrant close scrutiny, given the history of delays in NHS Electronic Patient Record programmes. Clinical workflow fit should be tested with representative users rather than assessed against generic feature lists. Vendor financial stability matters: the 2025 acquisition of Vision by OneAdvanced illustrates how ownership changes can affect product roadmaps. Alignment with NHS England's What Good Looks Like framework and, for social care providers, the Care Quality Commission's Single Assessment Framework are also relevant evaluation criteria.

▶ How is the UK care management system market likely to change by 2027?

Several structural forces are reshaping the market. Consolidation is continuing across all segments, with the number of viable platforms in each care setting likely to contract. Systems that have embedded ambient voice technology, clinical decision support, and predictive analytics into their core architecture are likely to hold a structural advantage over those relying on third-party integrations. Integrated Care Board-driven procurement is increasing pressure toward ICS-wide system standardisation, favouring vendors with cross-setting capability. HL7 FHIR compliance is moving from a future consideration to a current baseline procurement requirement, as interoperability mandates function increasingly as de facto filters in NHS procurement processes.