NHS Spine goes from strength to strength, with new digital services and supporting more transactions than ever before.

NHS Spine is the world’s largest public healthcare platform and forms part of the UK’s critical national infrastructure. It supports major NHS business applications, providing interoperability and the sharing of data across various healthcare systems. BJSS managed a major programme to rebuild Spine, securely transferring the entire NHS onto this new, improved system.

The legacy system was unwieldy and costly to maintain. It comprised a very large bespoke codebase, many servers and other hardware that relied on a large number of complex underlying software components, all of which were proprietary. The requirements were clear: build and deploy a replacement system to reduce development, support and license costs, and increase reliability, performance, and resilience.

A re-engineered system built using open-source products and agile ways of working

As the strategic delivery partner for NHS Digital, BJSS was engaged to completely re-architect, re-engineer and rebuild Spine using open-source products and agile ways of working.

The system uses open source rather than commercial products and was delivered iteratively using the award-winning BJSS Enterprise Agile® approach. This facilitated a rapid delivery, allowing for greater cost savings and reliability, and removing vendor lock-in. Spine is based on 12 open-source products, ranging from databases to developer tools. These software products are proven on an internet-scale, offering a viable alternative to commercial packages while delivering significant capital and operational cost savings.

Automation is integral to the ability to support rapid and cost-effective change. Spine now includes comprehensive end-to-end test, deployment, service recovery, and operational automation. This has resulted in a significant reduction in administrative overheads in comparison to the legacy system and has made it easier to make changes to the system.

The system’s new codebase is more efficient and easier to maintain, delivering a tenfold improvement in performance despite requiring just one-tenth of the legacy system’s infrastructure.

Processing over one billion transactions – more than four times the average load on the UK’s entire debit and credit card transaction system

With virtually no disruption or downtime, BJSS and NHS Digital delivered a major programme to rebuild Spine using open-source products, securely transferring the entire NHS to this improved system and delivering increased reliability, performance and resilience, and dramatically reduced costs. Resourcing and operational costs have been reduced by over £21m per year thanks to commodity hardware and open-source software. With the new system in place, the NHS is now able to respond more quickly to change.

Spine now supports over 500,000 health and social care workers in England and processes over one billion transactions every month – more than four times the average load on the UK’s entire debit and credit card transaction system. At peak, the system processes 3,500 messages a second – a number which is increasing as support for more digital services is added.

Spine makes it easier for NHS staff and third parties to securely share information between services such as the Electronic Prescription Service, Summary Care Records (SCRs) and the e-referral service (e-RS). BJSS has been closely involved in the integration of these services and the development of new digital services which can be rapidly built thanks to a fully supported set of APIs. For example, a new digital service for the London Ambulance Service has been developed to enable paramedics to securely access SCRs when in the field. Paramedics can access SCRs via their iPads, without the need for a smartcard or N3 (the secure national broadband network for the NHS), connection by authenticating using the new NHS Identify service. This is just one example of how NHS Spine enables the rapid development and integration of new digital services. BJSS continues to support the integration of fresh innovation that adds further functionality to Spine. This, in turn, is creating a more connected NHS and better patient experience.

All linked services rely on data managed by Spine, including; 65 million Summary Care Records and 92 million personal demographic records generated by 28,000 healthcare IT systems in 21,000 care organisations across the country. As a result, health and social care workers have greater and secure access to the critical patient information they need to deliver a high standard of care. Authorised third parties such as pharmacies, also have access to this secure data via the Electronic Prescription Service, which makes the prescribing and dispensing process more efficient.

Generating significant cost and efficiency savings for the NHS

According to NHS Digital, since the Spine system went live it has helped to save over £130 million for the NHS. Additionally, 750 working hours per day are saved, helping the NHS to improve its response times by 90%. These cost and efficiency savings are crucial to the health service’s ability to reinvest in vital front-line services.

As a result of the new Spine delivery, NHS Digital has become self-sufficient in agile ways of working and project delivery. By adapting the BJSS Enterprise Agile approach for use throughout the delivery of Spine, the NHS Digital delivery team was expertly coached in agile project delivery. The team has been able to reduce personnel costs by working with smaller teams of multi-skilled individuals. Additionally, the team can work more quickly while keeping risk to a minimum when carrying out complex projects.