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New NHS database will succeed with open source and agile, says supplier

Health Secretary Jeremy Hunt wants paperless NHS by 2018

The success of the NHS' new national database, dubbed SPINE 2, will be down to the use of open source technologies and agile development techniques, according to its supplier BJSS.

The original SPINE database was core to the previous government's failed National Programme for IT (NPfIT).

SPINE has delivered a national infrastructure service that supports programmes such as the Summary Care Record (SCR), Choose & Book (CAB), Electronic Prescription Service (EPS), GP2GP, Quality Management & Analysis System (QMAS), Secondary Uses Service (SUS) and NHS Number. The Spine handles vast volumes of transactions, it contains NHS Numbers and demographic data for over 70 million patients which is requested or amended more than 2.6 billion times a year.

It was also announced yesterday by Health Secretary Jeremy Hunt that he expects the NHS to be paperless by 2018, in a bid to extract £4.4 billion worth of savings a year out of healthcare providers. SPINE 2 will play a critical role in this.

Nigel Wilson, head of development for BJSS, the company selected in June of last year to work with NHS Connecting for Health to help build the new database, told Computerworld UK why the existing database isn't effective.

"Currently the system takes a long time to do releases and make changes to those releases, and as a result the NHS isn't getting the flexibility it needs to deliver services and respond to the demanding needs in primary healthcare," said Wilson.

"In terms of what the new platform will do, it moves away from a lot of proprietary software and a really heavy infrastructure, and reduces the number of NHS racks of servers down from hundreds to tens."

He added: "There is a huge amount of savings to be made - in terms of the running costs, the infrastructure and the man power to manage it."

Wilson wasn't willing to go into specifics about the cost of developing SPINE 2, or the expected savings that the new database will deliver.

BJSS has been actively working on the project for six months, and Wilson estimates that it is half way to being completed. Wilson also revealed that although BJSS has currently only been tasked with building the database, it is in discussions with the NHS to manage it after the project completes.

BJSS has said that it is using a number of open source technologies to avoid vendor lock in with SPINE 2, including Python, Flask Web Framework and Tornado Web Servers, but is also working very closely with the NHS using agile development methodologies, which Wilson also insists is key to the database's success.

Agile has become the poster child for effective and efficient development in the IT industry, but many departments struggle to implement it effectively. Government especially has tried to implement it where possible, but has come under fire in the past for not doing it enough.

"The current arrangement in typical public sector procurements is that you are locked into a big systems integrator for a long time, where they try and push all of the service delivery onto that provider. What we are doing now is working very closely in collaboration with the NHS, so there isn't a them and us culture," said Wilson.

BJSS will work with NHS Connecting for Health to build the core services of 'Spine 2' - PDS, EPS, SCR and TMS - in a series of iterative development blocks (each four weeks). The company will also develop options to replace the user interfacing systems that access Care Records and Demographics Services, while ensuring the existing external interfaces remain unchanged to ensure there is no adverse impact on existing connected systems.

"I think the key thing is the shift in the way of working towards agile principles, which really de-risks the programme - it enables early integration and reduces the chance of any problems," Wilson added.

"SPINE currently has 20,000 systems integrated into it and BJSS has already carried out a proof of concept that delivered a working service, which we have now pushed out and are doing early integration testing with the third party developers that hook into SPINE."


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