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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. 

Important updates

Important updates

Spine in the cloud

We are moving the NHS Spine platform to the cloud. Find out what you can do now to prepare for these important changes.

Switch hardcoded IP’s to use Spine's fully qualified domain names (FQDNs)

Some suppliers have hardcoded their connection to Spine to a specific IP address. This will cause issues during any site failovers on Spine. Find out what you can do now to prepare for these important changes.
Improve Transport Layer Security (TLS) version

Find out what you can do now to prepare for these important changes.


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

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.


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, which involves the re-hosting of our Spine services in the cloud.   

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)
  • MESH successfully replaced by a cloud-based version
  • tranche 2 business case
  • partnership agreed with delivery partner 
  • new MESH API go-live
  • new version of the NRL Futures API available through digital onboarding service


October to December 2023

  • live cutover of Spine site 1 - 5 October
  • live cutover of Spine site 2 - 12 October
  • power down Spine LIVE environments on-prem
  • start hardware decommissioning and disposal
  • remove all Spine hardware and exit from data centre

Latest events

We are currently confirming dates and times for our summer events. Please email the team at [email protected] to register your interest and to be notified when details are announced

Contact us

If you work in health and care and would like either:

  • more information
  • or to let us know what you need from the NHS Spine of the future

Contact the Spine Futures team: [email protected].

Last edited: 6 October 2023 3:15 pm