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Digital transformation

Our progress so far

Information systems

Since the publication of our last green plan in 2021, Moorfields’ digital teams have made strides in maximising the benefits of digital transformation to improve sustainability and patient care. Central to this work has been the ongoing development of OpenEyes, our bespoke clinical software solution. We are in the process of integrating OpenEyes with Meditech Expanse to develop our Electronic Patient Record (EPR), a solution which is set to go live in June 2026.  
 
As a result of OpenEyes development and work with our digital patient portal provider, we have rationalised our communication with patients – both appointment letters and outcome letters. Our patient appointment letters are now sent digitally as standard unless a patient specifically requests a paper copy. Benefits of this include faster communication and reduced loss of correspondence, which has improved patient experience while also reducing costs to the trust and CO2e emissions.  

There are approximately 657,000 appointments per year at Moorfields, each appointment resulting in 0.64kgCO2e per letter for paper and postage. The digitalisation of these appointment letters represents an estimated annual reduction in CO2e of 420,250.9kg CO2e. We also digitised clinical outcome letters in July 2025, which is projected to result in 218,553 avoided paper letters annually, equivalent to approximately 139,873.9kg CO2e.  
 
In terms of forms, we have introduced:

  • Digital consent forms as an option for patients and staff using a platform called Concentric. There is a potential reduction of approximately 100,000 pieces of paper per year by moving to a digital solution using both Concentric and OpenEyes.
  • Use of the WHO injection forms checklist which reduces the need for approximately 49,000 paper sheets per year
  • Use of the safer surgery checklist on OpenEyes which reduces the need for approximately 50,000 paper forms per year.

Moorfields went live with the NHS App in March 2024 and NHS app-appointment notifications and messages went live in June 2024. The app enables a raft of paper reduction opportunities and patient experience improvements relating to patient access to health information and communication.

By leveraging the NHS app as part of the Wayfinder Programme, we have achieved reductions in environmental impact of travel to appointments and appointment DNAs. This initiative received the HSJ Digital Award in June 2025 for reducing environmental impact of patient appointments while improving the patient experience. We now have 10, 000 patients per year accessing our A&E Attend Anywhere appointments – though work remains to be done to ascertain whether this is means a direct substitution from in-person appointments or a result of increased demand. 
 
We have removed paper print and scan from our external referrals process – the booking team now move scans directly from external referral emails into CITO/digital storage. This saves 380,000 sheets of paper per year at 0.009005 kgCO2 per sheet (3,421.9 kgCO2 per year).  

Hardware

We are upgrading printer and scanner stock across the trust. Our new hardware leasing and service contract with Xerox ensures increased energy efficiency and performance monitoring, which will help the trust to target print reduction activities further. We have rolled out new digital experience monitoring on desktops and laptops, which provides a dashboard view of sustainability metrics related to desktop and laptop use.

Change in practice

For paper reduction, the health records team has been working with clinical and operational colleagues across services to reduce requests for paper notes at outpatient clinics by improving reliance on electronic records.  
 
Paper notes are stored near Coventry and driven to hospital sites when requested for clinics. Reducing these requests provides cost savings to the trust and has the potential to deliver CO2e savings if deliveries can be stopped.  
 
We have reduced the number of clinics requesting and using paper health record notes by 75% via the development and embedding of OpenEyes (our specialist Ophthalmology care software) into care workflows and we continue with our efforts to reduce this even further.  
 
For staff, we have been utilising digital tools such as Microsoft Teams and SharePoint in working practices, enabling the trust to operate flexible combinations of office and home working, and the associated sustainability benefits. In addition, we have established an artificial intelligence (AI) working group and have considered automated processing.  
 
Over the last years we have also substantially transformed our approach to patient referrals and the way patients can access our care through digital innovation.  In 2023, we started streamlining direct referrals via our single point of access (SPoA) pathway to improve patient experience, minimise unnecessary travel, and increase building resource utilisation efficiency. Our implementation of local diagnostic hubs has brought care significantly closer to patients, significantly reducing the need for face-to-face appointments at our main hospital sites and reducing average appointment durations by 50%.  

Earlier this year, we developed a virtual neovascular age-related macular degeneration (nAMD) pathway and implemented rapid virtual triage across all sites. This project improved cost and sustainability of the pathway, for which we won the Aylward QIPP (quality innovation productivity and prevention) award. This project kickstarts our exploration of the broader applicability of virtual triage for other urgent ophthalmic conditions. 

Digital transformation plan

Actions KPIs
Maximise the benefits of digital transformation within our clinical services to reduce emissions and improve patient care. 
Develop OpenEyes software capabilities and fully implement our Electronic Patient Record (EPR) solution.  
  • Digitalise 100% referral request forms, 40% A&E letters, 100% clinics and theatres by June 2026. 
  • Improve staff access to digital tools and staff digital literacy (e.g. by May 2026 ensure all areas have access to the appropriate end user devices, complete digital literacy skills pilot and expand to all member of staff who need additional support by December 2025). 
  • Move all appropriate patients to digital pre–op (aim is for 18% of pre- op assessments to be virtual) avoiding appointments/travel and reducing paper. 
Reduce paper usage for clinical notes by introducing AI ambient voice transcription tool. 
  • Complete ambient voice pilot and business case to expand to all areas of the trust by December 2025. 
Reduce print associated with patient information leaflets via the promotion of digital access methods.
  • Trial use of QR codes in patient information leaflets and patient letters by September 2025. 
  • Roll out patient information QR codes across clinic screens. 50% by December 2025, 100% by September 2026.
Digitalise patient consent forms. 
  • Use Concentric to digitalise consent forms saving 100,000 sheets of paper annually. 
Continue to expand virtual patient pathways which reduce travel miles and the associated emissions for both patients and staff.  
  • Increase remote working for clinicians – review clinicians’ job plans/rotas and equipment so that clinicians can work from home or other sites ahead of our move to our new site in 2027. 
  • Expand the use of virtual pathways for all suitable pathways and patients by the time of our move in 2027. 
  • Transition from face-to-face to online translation where clinically appropriate, taking into account inequalities, by 2028. 
Explore AI opportunities via our AI working group to streamline executive, operational, and clinical workflows to achieve sustainability gains. 
  • Trial AI agents.  
  • Incorporate Smart Hospital technologies into new centre in 2027. 
Embed sustainability in digital services by using circular and low-carbon approaches to IT hardware management. 
Reduce the energy consumed by idle equipment through cultural and technical initiatives to promote proper switching off energy drains on devices not in use. 
  • Identify education needs and approach around switching off of computers.
Build up energy use monitoring across the IT portfolio and work towards a joined-up whole system of real-time monitoring to enabled targeted efficiency and sustainability initiatives. 
  • Replace City Road data centre and Ebenezer Street data centre with two state-of-the-art data centres by 2027-28. 
  • Take up energy improvements around shift to new data centres by 2027-28.
Provide digitally excluded patients with donated devices, reducing trust waste and CO2 emissions via reuse. 
  • Consider scale of the potential in 2026 and agree next steps.  
Embed sustainability in IT Infrastructure, data management, and engagement with digital suppliers. 
Promote good data hygiene via deduplication and archiving.  
  • As part of MoorConnect, decommission a set of legacy systems and optimise data hygiene by June 2026. 
Reduce carbon emissions from discretionary changes including staff email signatures, green search engines and other initiatives. 
  • Remove images from staff email signatures via MoorGreen promotion in 2026.