An introduction to standards and interoperability at NHSX

Interoperability is when different systems and products can seamlessly exchange, making use of data and information across system and organisational boundaries. It is a decades-old challenge and a long-time priority. While there’s still a long way to go, we have a plan.

What is interoperability, and why are standards important?

Interoperability depends on widely-adopted open standards. Take the internet for example. No singular organisation owns the internet; no single product or piece of software is needed to allow users to browse the web, create websites, send and receive emails.

This capability is enabled by a range of standards (or protocols), the adoption of which provide interoperability. Because all browsers and email clients are exchanging information using common standards, users can choose what browser or which email client to use, with messages and information transferring seamlessly across systems.

Interoperability in health

The NHS and care sectors are too diverse for a one-size-fits-all single IT system to be the answer. Equally, letting a “thousand flowers bloom” can lead to thousands of different systems that do not speak to each other.

The only way that tech can work in a complex health and care system is for clear, open standards to be set, effectively incentivised and enforced where appropriate. Local providers can then make their own choices, and as long as what they do and buy is compliant with the standards then everything will slot together and systems will be able to communicate with one another.

The benefits of successfully delivering an interoperable health and care system are huge: improved patient safety through reduced errors; more integrated care by making the right information available at the right time and at the right place; a thriving and innovative healthtech sector with usable apps and products; people able to access their own information and supporting the use of data for population health, policy making and research.

By ensuring interoperability across systems, we avoid delays in diagnosis, prevent tests from being repeated unnecessarily, and speed up the process of starting people on the correct treatment and care. This transforms care provision by giving permitted staff instant access to people’s care records, and makes it easier for people to move between care settings.

Understandably, standards and interoperability has long been a priority. The Wachter Report which concluded in 2016 stated that:

The new effort to digitise the NHS should guarantee widespread interoperability ... to enable seamless care delivery across traditional organisational boundaries, and to ensure that patients can access all parts of their clinical record

In 2019 the NHS’s Long Term Plan in 2019 built on Wachter by committing to:

Mandate and rigorously enforce technology standards ... to ensure data is interoperable and accessible” and “requiring every technology supplier to the NHS to comply with published open standards to enable interoperability and continual improvement

While important progress has been made, the interoperability agenda has further to go. The Standards and Interoperability team at NHSX has been established to take it forward.

What we're doing

Our goal is to deliver tangible benefits to the health and care service by developing and improving the governance, framework and processes to support standards which get widely adopted across the system.

The process for standards development and compliance will be streamlined through a robust model for standards development and implementation. This will be supported with clarity on what exists, what is required and which suppliers and systems are conformant.

NHSX will lead the work to establish fit-for-purpose interoperability standards, working closely with NHS Digital, the wider NHS, the social care sector, standards bodies and the vendor community.

Five key priorities

Our team is focused on 5 key priorities.

1. A new end-to-end process and governance model for standards development

This will ensure that new standards are fit for purpose and co-developed with key users and with active open engagement with relevant communities throughout. The end-to-end model will communicate clear accountabilities, responsibilities and handoffs for the entire model from priority setting through to adoption, maintenance and deprecation of standards.

2. Standards and Interoperability Strategy

Publishing our Standards and Interoperability Strategy, which will outline our vision for a health and care service where interoperable systems are ubiquitous and the benefits of adoption are clearly understood by clinicians and technical staff alike. The strategy will provide the framework for our overall objectives, guidance and guardrails for addressing the key challenges to interoperability and expand on our commitments in the Data saves lives: reshaping health and social care with data strategy document.

3. Open source playbook

We will publish our open source playbook, which will provide tangible guidance and advice to providers and commissioners looking to adopt and implement open source solutions.

4. Long-term roadmap for standards and interoperability

A long-term roadmap for standards and interoperability will set out the pipeline for new standards and priorities for the implementation of existing standards. It will include a timeline for moving from one version to another and will assist vendors, providers and commissioners with planning and development.

5. The standards portal

Finally, we will launch a new service, the standards portal, that will include a registry of standards used across health and care. It will bring together standards by use-case, provide clarity on which standards are applicable, and will enable vendors, providers and commissioners to search for and easily locate the artefacts needed for implementing a standard. The portal will be supported by community features to enable greater collaboration and sharing around standards development, maintenance and adoption, which we will seek to establish and nurture over its lifetime.

In the coming months, each of these priorities will be the subject of an in depth blog post which will provide additional context and detail on how, what and when we will be delivering on these projects.

Get in touch and get involved

This is part one of a series of blog posts articulating our vision and priorities for standards and interoperability. Our next post will describe the plan for designing a new standards portal and provide some detail on the process and history of the project.

If you would like more information about the programme please direct your enquiry to interop.standards@nhsx.nhs.uk.