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What does the future NHS Spine look like?

Shan Rahulan and Mark Burton describe plans to modernise the Spine platform and invite IT professionals to help shape the future.

How do you connect 26,000 healthcare organisations and allow information to safely and securely flow across national and local IT systems in England?  

Two healthcare workers using digital devices

For the past 20 years, there has been a one-word answer to this question:  Spine.

The Spine platform has been providing critical healthcare infrastructure through a collection of national services, such as the Personal Demographics Service, Summary Care Record and Electronic Prescription Service.

The current version of Spine was launched in 2014 and performs brilliantly, handling more than 1.3 billion electronic messages a month. At peak demand, it can process more than 3200 a second.

However, the advancing digitalisation of health and care means there is a growing demand for information exchange across health and care settings in England. How should Spine evolve with these changing and growing demands? And how do we make it happen?

Is it clear to consumers what the products in the Spine portfolio offer?

The Spine Futures programme was created to tackle these challenges. Over the next 2 to 3 years, we’re building a new, scalable Spine platform to replace the current one. We will be moving Spine products to the cloud, strengthening our resilience against potential future cyber-attacks, while changing to a product-centric operating model and ensuring all NHS architecture principles are complied with.

Spine Futures vision:

Provide a secure, adaptable, and sustainable infrastructure for the health and care system in England, enabling data integration between care settings. This will create a platform for national digital services to be built upon to meet current and future needs of staff, patients and the public.

Spine Futures also provides us with an opportunity to review whether Spine is meeting its users’ needs. Is it clear to consumers what the products in the Spine portfolio offer? Are there gaps in the current service provision?

To make sure we’re doing this, we’re inviting IT professionals across health and social care to attend bi-monthly webinars to have their say over our future plans.

Into the cloud

In December last year, we had our first major milestone in the Spine Futures programme when we successfully replaced the Messaging Exchange for Health and Social Care (MESH) with a cloud-based version.

MESH connects more than 22,000 health and care organisations all over the country, enabling them to share a wide variety of data securely and reliably and at scale, with about 40 million files transferred a month.

The release and subsequent ‘hypercare’ period (where we offered an elevated level of support for people adopting the new system) for the migration to the cloud was an overall success and will act as a blueprint for future Spine migrations.

This success was made possible by combining the effort of our engineering and service management teams. The engineering team developed a robust and well tested infrastructure and we then worked closely with colleagues in our Service Management and Tech Operations teams. For example, we had a ‘triage game day’ where we mimicked various issues and then worked together to fix them. This sort of training day was a first for us, and something we’ll take forward for future migrations.

We have come away with ideas on how to get better engagement with IT suppliers in the integration testing environment, swiftly stand up our internal project teams and processes and efficiently monitor and triage errors.

We are applying what we have learned as we plan the rehosting of Spine service into the cloud. 

Early wins

Some of the early benefits we look to realise through the programme are:

  • Improved customer satisfaction by making it easier to access and use the MESH product suite
  • efficiency savings from moving to the cloud and a product-centric operating model – for example, by reducing the development cycle
  • compliance with NHS architecture principles 
  • reduction in carbon emissions and improvement in sustainability from migrating to cloud infrastructure
  • reduction in support requests made through product improvements such as improving the client installation
  • time savings – for example, by making it easier for new suppliers to integrate with Spine services
  • cost reduction – for example, by using cloud-native tooling and services to reduce both development effort and cost

If you are interested in learning more about the programme or would like to be involved in developments you can go to our webpage or contact the team.

Related subjects

NHS Digital are developing a new, scalable platform to replace the current NHS Spine over the next 2 to 3 years. The Spine of the future will make use of modern technologies and open standards to meet the current and future needs of patients, staff, and citizens. 
The Cloud Centre of Excellence (CCoE) promotes a best practice approach to drive the adoption of Cloud services. It provides a centralised enablement function and supports Cloud service consumers across NHS England and the wider NHS.
Neil Gibbs, Cloud Engagement Lead at NHS Digital, says we need more NHS organisations to migrate to the cloud and explains what help is available.
Earlier this year, we talked to our strategic partners across the public and private sectors about how we can evolve our Spine platform to meet the needs of a future health and care system. Ash Raines, Head of Delivery for the Platforms Directorate, shares the key themes and insights we’ve learned.


Last edited: 16 March 2023 4:30 pm