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Path to Live environments

Find out how to connect to the Path to Live environments. Service information, including user guides and common issues, as well as change details and news are also available. 


The following environments are available for users to connect to.


The development environments are used by suppliers who are implementing the design, development and system test phases within their own test environment(s). They are also used to perform early testing against the Spine Core, Spine Care Identity Service (CIS) and NHS e-Referral service (e-RS) national systems.


The integration environments are used for integration testing which proves the end to end capability of messaging between the supplier’s test environment and a Path to Live test environment. It may include testing of new supplier releases as well as regression testing of their existing releases against new Spine Core, Spine Care Identity Service and NHS e-Referral Service national releases.


The deployment environments are used to test applications in-situ before live deployments, to help suppliers and NHS organisations develop local site processes, procedures and create a local change process. The deployment environments are also used for user acceptance testing (UAT) with NHS organisations.


The training environments are used by suppliers to train staff on Spine Core messaging and Spine Care Identity Service. It should not be used for any type of testing and undergoes a nightly refresh of application data so it can be re-used in subsequent training exercises. The NHS e-referrals service has its own training environment. Please contact [email protected] for details of how to connect to this environment.


The opentest environment is used by suppliers who are performing messaging proof of concepts of their solutions against the Spine Core national system.

Non-functional testing 

The non-functional test environment is used by suppliers to perform specific messaging integration testing. Access to the environment can be requested via the Platform Support Desk. 


The Production environment is not supported by the Platforms Support Desk. Any queries regarding any aspect of the Production environment should be directed to the National Service Desk. We have however maintained the Production certificates for your convenience

Environment build versions

Current versions of the national system applications deployed in each Path to Live environment.


The following services are available across the Path to Live environments.

Spine Core messaging and Spine Core applications 

The Spine Core service provides a messaging service that allows certified endpoint message handling systems to query and update data held in the national systems. 

The Spine Core system also supports the e-RS national system by providing a messaging interface between e-RS and referrers and providers. Also included in the Spine Core service are the Graphic User Interface (GUI) based Summary Care Record application (SCRa) and Demographic Spine Application (DSA). These allow Spine Core data to be accessed and/or updated without a messaging interface.

The SCRa application also allows access to some specialist data such as migrants and visitors. 

Spine Mini Service Provider 

Spine Mini Service Provider provides a simple interface to local systems for demographic messaging, allowing quick recovery of details without the requirements of full integration. Messaging functionality is limited to queries. 

Spine Secure Proxy

The Spine Secure Proxy provides an access control layer required by certain programs where patient data may be made accessible to certified users and systems.

Message Exchange for Social Care and Health (MESH)

The Message Exchange for Social Care and Health (MESH) provides a workflow based data transfer service that allows registered users to exchange data between secure mailboxes. It is used to support services such as the transfer of Pathology data between labs and hospitals and electronic discharge notes to community medical teams for patients leaving hospital care.

Care Identity Service (CIS)

The Care Identity Service (CIS) controls user access to data held in the national systems. Users access is via a smartcard and uses Role Based Access Control (RBAC). Both smartcards and Access control are managed within the CIS application. Certification and management of message handling systems is also managed within the CIS application.

NHS e-Referral Service (e-RS) 

The NHS e-Referral Service (e-RS) allows patients to book a choice of available hospital or clinic appointments based on the patients preference. Patients can book their appointments in the GP surgery at the point of referral, or later at home, on the phone or online. 

NHS e-Referral Service Application Programming Interface (e-RS API)

The NHS e-Referral Service API system allows patient systems to perform clinical actions within the e-RS application via an external API interface. These APIs can be configured by the user community and submitted for approval by NHS Digital.  More information on the e-RS API Service and useful starting information is available.

Test data

For details on what test data is available, and how to set up your own test data, see setting up test data in our path to live environments.

Forward change schedule

Find out details of planned changes and how these will impact on environment availability. 

Change success report

Find out the success status of changes made to the environments.

Request Splunk Cloud Access

Find out how to request access to Splunk Cloud.


Latest news

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Email: [email protected]

Contact us

Report an incident

If you have an account, you can use NHS Digital's service portal to log the incident. You will need to have access to the Health and Social Care Network (HSCN) to register for an account. 

Otherwise, please use the online incident reporting form (opens in a new window). 


Your feedback is important to us to help improve our service. Use our feedback form to share your experience of the Environment Management Team (opens in a new window). 

Further information

Email: [email protected]

Further information

internal Connect to a Path to Live environment

NHS Digital provides a number of Path to Live testing and training environments. This page describes the process you should follow to successfully connect to these environments.

internal Forward change schedule

An overview of all changes scheduled to be implemented in the Path to Live environments.

internal Change success report

The status of all changes implemented in the Path to Live environments in the last 24 hours.

Last edited: 3 November 2023 8:11 am