Secondary Care

Opinion: Being open to innovation

The creation of NHSX and its commitment to open development could herald a new era of closer collaboration between the health service and software companies, considers David Hancock, healthcare executive advisor at InterSystems. By working in more open and collaborative ways, he believes vendors and the NHS can better deliver innovative solutions that will directly benefit patients.

At the launch of NHSX health secretary Matt Hancock announced that that all code used in healthcare software should be open source. As the NHS matures digitally, Hancock wants it to embrace “open standards, secure identity and interoperability,” a vision he previously outlined in The Future of Healthcare published in late 2018.

The use of the term open source is potentially confusing here. NHSX isn’t insisting that open source won’t be globally applicable or compulsory. Instead it recommends that all new software that is developed within the NHS – either built by its own staff or commissioned directly by NHS organisations – is based on open source foundations.

This isn’t about edging out existing providers or replacing them with ‘free’ software, but about increasing transparency and transferability. Fundamentally, NHSX is looking to ensure that any new developments interact and exchange data seamlessly with established systems like PAS and EPRs that are already having a positive impact on productivity and patient outcomes. By making them open, they’re making them accessible – to us and other providers.

In time, we are likely to see the establishment, under the auspices of NHSX, of more common standards and shared expectations around interoperability and collaboration. It’s less about open source here, and more about embracing an open approach to development – finding efficient and effective ways that we can work together to improve software and systems.

Innovate or die

As the NHS becomes more digitally mature and technologically advanced, it is facing significant challenges – and so are those organisations who supply it. To survive in this new world, existing vendors will need to become more open in their approach, ready and willing to collaborate and, when the time comes, to effectively integrate new pieces of software and work with new providers.

The larger players will have to innovate – reinventing themselves to survive, adapting their approaches and business models to this new NHS strategy and the market drivers behind it – as they have always had to do.

It’s more difficult to assess the impact on smaller providers, but it’s likely that some will adopt the standards and seek innovative ways of providing more agile software services, while others may not move quickly enough.

It’s not just software companies that need to change. Reflecting on the NHS itself, positive words won’t be enough. Successful collaboration and open development need to be matched by the NHS with investment in capabilities and capacity, along with commitment to fund and keep up with innovations. To truly succeed, NHSX needs to put its money where its mouth is.

Innovative mind-set

For those with a long history of working with the NHS it’s easy to be cynical about highly-publicised launches and bold new aspirations for the NHS, but the establishment of NHSX – and the clarity of vision outlined in the Long-Term Plan – appears to be a genuine attempt to change the way the NHS uses technology and develops new software.

High quality innovative solutions and software should be welcomed, shared and exploited to their full potential, irrespective of where they come from. It is also clear that open source alone won’t solve the NHS’ problems – by working more closely together and embracing an open development approach, the private and public sector can more effectively tackle the problems of tomorrow, today.