UK NHS Delivers Ambitious Health IT Project - Believed to be the Biggest of its Kind

Press Release | HSCIC | February 17, 2016

An NHS IT project has successfully completed the final phase of its plan to move the entire technological backbone of the NHS from a private company to in-house, public sector management.

17 February 2016--HSCIC has just completed an ambitious 18 month transition project to entirely rebuild and redevelop the Spine on Open Source software and to move it to in-house management. This was achieved without disrupting the service it provides to 28,000 organisations and enabled the secure transfer of almost 150TB of data, including the demographic details of 80m people.

The new Spine is believed to be the biggest public sector IT system to be built entirely on Open Source software, making it easier for developers to work with. It is managed from the Health and Social Care Information Centre's headquarters in Leeds.

The system has saved £21m in its first year; has operated at 100 per cent availability since August 2015; and saves the NHS a staggering 750 working days of time every single day.

The NHS Spine is the technological backbone of the NHS and allows safe care to be delivered to patients. It is part of the Critical National Infrastructure, supporting care and enabling a smooth running NHS for around 28,000 organisations, including hospitals, GP surgeries, Ambulance Trusts, NHS 111 services and pharmacies. Operating 24 hours a day, 365 days a year, it handles up to 1,800 transactions per second.

Spine connects clinicians and patients to essential national services including the Electronic Prescription Service, Summary Care Record and the e-Referral Service, which allow clinicians to deliver safe and effective care to patients.

Rob Shaw, Director of Assurance Services, explains, "The usual practice for a big public sector project like this has been to give the whole thing to a large supplier. We decided that we could manage and make improvements to Spine more flexibly in house, and have worked with a number of specialist SMEs to successfully deliver our aims.

Rob Shaw, Director of Assurance Services"The NHS relies on the Spine in order to operate effectively, and we couldn't afford for it to experience long periods of downtime. For this reason we planned the transitions minute by minute to ensure that we would not affect patient care or inconvenience NHS workers any more than was absolutely necessary. In the end we managed the entire transition with just minutes of downtime, none of which was unplanned."

The first transition was completed in August 2014, when the Core Spine services were transferred to the HSCIC. In February 2015 the Care Identity Service, which manages secure access to IT services for NHS staff; and the SUS database, which holds 80m patient demographic records, was smoothly transitioned. The project was completed on 31 January 2016 when MESH was launched and HSCIC took on responsibility for managing secure clinical messaging between Spine applications. This is particularly important for pathology and other test results, which are sent directly from the laboratory to the appropriate clinician using this system.

The new service has not primarily been designed to save money, but principally to allow Spine to be developed in a way that is faster and more responsive to user needs. Improvements have already been made since Spine was transitioned, including the introduction of a range of new services and in the coming months HSCIC will develop and launch new methods for logging on to Spine, allowing mobile access to Spine services.

Rob Shaw explains, "We wanted to develop a service that HSCIC and developers could work with and adapt, to suit the needs of individual NHS organisations. The entire system is built on Open Source, freely available software, which makes it much easier to work with and develop. The team working on Spine operate an Agile working method, which makes it much faster to improve and change the service. We are all proud of what has already been achieved and excited to continue to develop the service in the future."


1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 260 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.