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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. 


The Spine Futures programme has been created to transform Spine, maintaining the secure, reliable infrastructure with a vision to:  

Build more open platforms that continue to provide critical healthcare infrastructure, better adapt to changing user needs, and support the development of new and innovative services. 


The Spine Futures programme has 6 objectives.

Engaging the system

We want the Spine of the future to make the best use of modern technologies and open standards to ensure it meets the needs of NHS users for many years to come. That's why we're actively engaging the health and care system with the development of the Spine Futures programme. 

Currently, we are working with global technology leaders on recommendations for scalable real-world solutions, based on user research. We are gathering views and feedback from health and care system suppliers and working with teams in social care and frontline digitisation. 

We are keen to engage with NHS teams who are currently using, providing support, building on, or have Spine products or services in their roadmaps to find out their needs for Spine.

Please contact us using the details below if you are interested in hearing more. 


The Spine Futures programme started in April 2022. A core element of the programme is to move Spine products to cloud.

We have followed the 7 Rs industry standard approach for cloud migration, and chose a few services with which to explore the approach and to understand the scale of the challenge.

We are focussing initially on Messaging Exchange for Health and Social Care (MESH) and National Record Locator (NRL). We are assessing other Spine products and considering the most effective migration approach to move them to cloud. The approach is informed by the learning and challenges uncovered from these first two products and the complicated nature of Spine architecture. We are in the process of procuring a large delivery partner to continue the next phase of this work.  

Achievements so far

Achievements so far include:

  • MESH API now available through digital onboarding service
  • Benefits baselined and tracking in place
  • Cloud migration assessments completed for MESH, NRL, Electronic Prescription Service (EPS), Spine Secure Proxy (SSP) and Subject Access Requests (SAR)


January to March 2023

  • tranche 2 business case
  • partnership agreed with delivery partner 
  • new MESH API go-live
  • new version of NRL Futures API available through digital onboarding service

Contact us

If you need more information, you can contact the Spine Futures team at

Last edited: 2 November 2022 4:23 pm