The NHS is to develop new data and technology standards with the aim of improving the interoperability of digital systems, under a new approach made public today by the Department for Health and Social Care (DHSC).
It will also involve a commitment to internet and public cloud first, along with the building of a data layer with registers and open APIs.
The details have been revealed in a vision document, The Future of Healthcare, which says interoperability has been poor and sets out the architectural principles for digital systems in the NHS.
Health and Social Care Secretary Matt Hancock (pictured) said: “The tech revolution is coming to the NHS. These robust standards will ensure that every part of the NHS can use the best technology to improve patient safety, reduce delays and speed up appointments.
“A modern technical architecture for the health and care service has huge potential to deliver better services and to unlock our innovations. We want this approach to empower the country’s best innovators — inside and outside the NHS — and we want to hear from staff, experts and suppliers to ensure our standards will deliver the most advanced health and care service in the world.”
The document states four guiding principles for developing healthcare technology – meeting user needs, maintaining privacy and security, interoperability and openness, and inclusion for everyone – and follows up with more detailed architectural principles for digital services.
Disperse datasets
Among these is a plan to build registers of data with open APIs, which would support the creation of small, dispersed datasets. These would make it possible to deliver services and facilitate research without large databases.
Alongside this are commitments to adopting internet standards to support an ‘internet first’ approach to new services – thereby avoiding a centralised infrastructure – and to ensure all digital tools work within modern browsers. This would remove the need for users to pay a software provider or app store to use services, support their use on mobile devices, and open up an ecosystem of service designers.
This will be accompanied by a ‘public cloud first’ approach, which would remove the need for locally managed servers and provide the desired levels of resilience and scalability for services.
Other architectural principles include adopting the best cyber security standards and separating the layers of the NHS’s patient record stack. The latter involves having separate contracts for hosting, data and digital services, with the scope to improve and upgrade each layer without disrupting the others.
The document emphasises the importance of open standards, with a commitment to the creation of national standards for data, interoperability, privacy, real time data access, cyber security and access rules. These will be in line with the Government’s Open Standards Principles and are set out in a separate technology standards framework document, which conveys the early thinking and expectations of their use.
All new IT systems will have to be built in line with the standards.
Market emphasis
There is also a strong emphasis on the role of the private sector in developing the technology. The document says the NHS should only build nationally the few services that the market cannot provide, and that it must be done once for everyone.
This may mean that some programmes – which are unspecified – are terminated before completion.
In addition, a new Healthtech Advisory Board is being set up as an ideas hub and chaired by Dr Ben Goldacre. It will include tech experts, clinicians and academics and report to the secretary of state for health.
Sarah Wilkinson, chief executive of NHS Digital, commented: “Everyone understands the value of this work but progress in recent years has been limited. Today, responding to a direct challenge from the secretary of state to transform the fortunes of this work, we are injecting a new level of energy and commitment.
“NHS Digital is providing a new clear framework to simplify the guidance on those standards that matter most. We are going to build the detailed guidance on these standards in partnership with technologists across the system and with industry partners.
“We recognise that the implementation journey is complex. Through consultation we will seek to understand in detail what the challenges are for different parties and throughout implementation we will focus on providing clear specifications, detailed guidance and extensive support."
Image from GOV.UK, Open Government Licence v3.0
