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Part of NHS Digital Annual Report and Accounts 2019 to 2020

What we did in 2019-20: Platforms and Infrastructure

We continue to improve our national infrastructure by connecting platforms and applications to support efficient and effective health and care delivery. We enable the development of digital services that support patients from cradle to grave, help clinicians in accessing, analysing and sharing information, and provide the public with relevant and timely health and care information.

photo of nurse using services on a computer in a hospital ward

Staff have faster and more reliable connections after University Hospital Plymouth NHS Trust moved to the Health and Social Care Network (HSCN).

The coronavirus response underlined the vital importance of our platforms and infrastructure in creating a stable and secure foundation, which has made agile delivery of new digital services possible.

Our Spine platform remains the backbone for NHS service delivery, providing secure access to core products including 65 million Summary Care Records (SCRs) and over 90 million Patient Demographic Service records. August 2019 marked five years since the Spine was brought in house to NHS Digital. In this time, it has saved the NHS more than £150 million.

Today, the Spine processes 3,500 messages per second, links to 28,000 IT systems, supports 21,000 care organisations and gives data access to over half a million NHS professionals each day. Despite the increased data storage capacity demands this year (up 27%) it has remained exceptionally reliable, 24 hours a day, 365 days per year, with zero down time required.

We have also applied world-class product design, engineering and software development skills to transform key digital services with our system partners. During 2019-20, this included:

The Data Processing Services platform enables us to collect, process and access data in a smarter, more efficient way, using leading privacy technology. By moving the data to secure cloud technology, we reduce potential security risks associated with storing data across separate systems.

We have also introduced a de-identification process that protects patient privacy by removing the identifiable information from a patient’s record so it can be safely used for research and planning. All information is encrypted in transit and when stored. This leads to faster access to better linked data and provides valuable insight. It drives research into the prevention and treatment of diseases and supports the planning and management of services and therefore the sustainability of the NHS.

The National Events Management Service allows patient-centric event messages to be published from one system and distributed to other subscriber systems in a timely manner.

Digital Child Health went first in March 2019, which included the ability for Spine to send Patient Demographic Service events such as changes of address or GP, birth and death notifications to child health organisations, health visiting services and approved national app providers. An ‘Explicit Subscriptions API’ was developed to allow users to subscribe to specific events for a patient under their care, using their unique NHS number. In October 2019, a ‘Publish API’ was created to help third-party suppliers provide information on events such as newborns’ hearing tests and physical examinations.

The National Record Locator permits authorised users to find specific patient records that are held on different health care systems. We have connected the information held in acute trusts, mental health providers, ambulance services, primary care, social care, public health (drug or alcohol) services and the voluntary sector, so that care pathways can be designed around patients’ needs. We are empowering health and care professionals with faster access to vital information, saving time and improving service delivery.

I was immediately able to find out that the patient had a mental health crisis plan and then find the right people to help him. I didn’t have to dispatch an ambulance.

We are also responding to the government’s Internet First vision by prioritising internet access to key national services and platforms. All new applications will be developed for, and run on, a public cloud service, improving interoperability through adherence to open data and technology standards.

We are using the new Health and Social Care Network implementation as a secure bridge from our current private network to an internet-facing one and we are leveraging commercial arrangements to achieve this vision. An example of this is the discounted access to VMware Cloud on Amazon Web Services announced in May 2019, which will eventually allow NHS Digital to reduce its data centres.

We have also completed the migration of the NHS e-Referral Service, which handles 18 million booking referrals a year, and the NHS 111 Directory of Services, which provides real-time information about available services and clinicians for patients who need to access medical attention in their community. By continuing to migrate services to the public cloud, we will be able to decommission legacy infrastructure.

In 2019-20, we have started to design and build an application programming interface (API) platform, creating new developer resources, APIs and standards that make it easier for the developer community to work with us. We are encouraging partner organisations and the health tech industry to leverage our data using new open APIs. Our first Patient Demographics Service API is in beta testing, with further APIs planned to go live in 2020-21.

Our strategy is to accelerate the digital transformation of the NHS by unlocking the potential of our technology platforms, improving access to data and driving the growth of a diverse, innovative and competitive digital health and care sector.

Last edited: 15 July 2020 6:07 pm