The NHS National Programme for IT (NPfIT) is one of the largest civilian IT programmes in the world. Key to the success of this £6bn undertaking is its central architecture, known as the 'Spine'.
Background
ASE provided thought leadership, architectural standards and detailed design for this significant architecture and infrastructure programme and has been built exactly in accordance with ASE’s Service Oriented “Conceptual Architecture”.
This is a significant integration exercise both upstream, where we have services supporting diverse business processes, and downstream, where there are now over one hundred different suppliers sending their various types of transactions through the Spine.
Approach
Business services delivered
At the heart of the Spine is a Transaction and Messaging Service (TMS) which is a combination of COTS and bespoke engineering. It is a hub which handles all the interactions between the end user systems (ultimately over 800,000 users, with over 500,000 currently registered) and the required services. TMS already handles several million transactions per day and will eventually process 10 billion a year.
Other business services that have successfully been delivered to complement this national infrastructure are:
- Personal Demographics Service (PDS), which holds non-medical personal data.
- Personal Spine Information Service (PSIS), which holds clinical summary information.
- Clinical and Demographic Spine Application Services (CSA, DSA), which allow users to view and maintain information.
- Electronic Prescriptions Service (EPS), which handles patient prescriptions.
- Choose and Book application, which handles referrals to secondary care.
- GP to GP transfer service (GP2GP), which is used to electronically transfer a patient’s record to new GP.
- Secondary Uses Service (SUS), which is holds a huge amount of information for “anonymised” use.
Outcome
A secure, standards based infrastructure
Key to this level of information sharing and interoperability is a full specification based on accepted standards for health interactions, clinical documents and clinical coding using reliable transport mechanisms to services based on accepted standards for web services.
ASE made the decisions to use these proven standards. Given the sensitivity of personal health information there has to be a commensurate level of security: a level at least as high as that used in the financial service industry. Taking Cabinet Office advice on handling clinical information, ASE implemented an e-Gif Level 3 solution. This is a smartcard based Single Sign On (SSO) architecture using a X.509 based certificate approach to a Public Key Infrastructure (PKI). Again, as far as possible, a standards-based approach.
On 19th May 2008 Gartner published a case study under the title “Architecting an Emergent Business Ecosystem at the U.K. National Health Service” (ref G00155414 © 2008 Gartner, Inc) recommending this approach to other Enterprise Architects.