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Creating a new NHS England: NHS England and NHS Digital merged on 1 February 2023. More about the merger.


Spine supports the IT infrastructure for health and social care in England, joining together over 44,000 healthcare IT systems in 26,000 organisations.

Spine allows information to be shared securely through national services such as the Electronic Prescription Service, the Personal Demographics Service, the Summary Care Record and the e-Referral Service

It currently handles over 1.3 billion messages a month and at peak times is processing more than 3,200 messages a second.

NHS Digital develops and maintains Spine. Recent developments include enabling the sharing of child protection information via the Child Protection Information System, and developing ways to allow easier access to demographic data through the Spine Mini Service.

Use Spine

Most users access Spine through clinical systems or through the Spine portal.

New ways are being developed to help systems suppliers design IT systems for health and care which can integrate with Spine or access important patient information.

Contact the NHS national service desk for more information. Phone: 0300 303 5035 or email:

Contact details

Our National Service Desk (NSD) can provide support and can escalate issues, where required:

Telephone: 0300 303 5035


Report via our customer portal

Further information

internal Spine Futures

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. 

internal Spine technical information: Warrantied Environment Specification (WES)

Computer systems which access NHS England services through Spine have to meet certain technical standards. The Warrantied Environment Specification (WES) defines the client environments that we support and applications requiring a smartcard or other approved authenticator to be aligned with the terms and conditions.

internal Reasonable Adjustment Flag

The Reasonable Adjustment Flag is a national record which indicates that reasonable adjustments are required for an individual and optionally includes details of their significant impairments and key adjustments that should be considered.

Last edited: 14 March 2023 3:07 pm