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“On a mission to make integration easier” – results from the 2023 NHS Digital developer integration survey

The results from the 2023 NHS Digital developer integration survey, to find out more about what developers have had to say about integrating with the NHS’s APIs, have been published. Although improving significantly in terms of overall satisfaction, findings suggest that there remain “key pain points” for software developers.

In the survey, NHS Digital asked developers to rate on a 1-to-5 point scale a number of different areas, also asking for feedback on potential improvements or changes. Those taking part in the survey were mainly from larger companies with more than 100 employees, and most of the companies that took part were in the business of commercial software development, working on solutions from patient-facing apps to GP software.

The six areas NHS Digital asked developers to rate them on were learning, design and build, testing, onboarding, help and support, and overall.

Learning – documentation and tutorials

Under this category, an average score of 3.67 was given, which it noted is an increase “from 3.1 and 2.1 in previous years”. Positive comments included “a breath of fresh air”, “on par with what we find in the private sector” and “well laid out and explained”. Suggested improvements included “multiple portals when a single one would be helpful”, “too many places to find documentation, it doesn’t seem centralised” and “hard to see what has changed when FHIR APIs change”.

Design and build integration 

NHS Digital scored an average of 3.74 under this header, up “from 3.1 and 2.4 in previous years”. Positive comments left by developers included “generally good with useable code examples” and “since the move from spine mini service to the new REST API the integration has been relatively easier”. Suggested improvements included “wasn’t an example in our chosen language, Node” and “dependence on JWT complicated integration”.


Under “testing”, NHS Digital scored an average of 3.6, up “from 3.0 and 2.3 in previous years”. Positive comments included “having integration environment APIs is great” and “included Postman collection is perfect”. Suggested improvements included “it would be good if the available test data sets were made more easily accessible” and “the call rate limit makes it really hard to test”.


An average score of 3.31 was generated for NHS Digital in this area, up “from 2.9 and 2.1 in previous years”. Positive comments included “digital onboarding is a HUGE improvement from the Excel documents” and “digital onboarding is much easier and allows you to make progress in stages”. Suggested improvements were “it would be very helpful to understand the requirements prior to the formal onboarding process” and “a bit too much silos between teams/departments within NHS”.

Help and support

Developers scored 3.77 on average under this heading, up “from 3.5 and 2.5 in previous years”. Positive comments included “NHS API people tend to be friendly and helpful” and “the new dev community will be a welcome addition”. Suggested improvements included “a simple video reply would be great” and “variable again. CIS2 onboarding excellent due to dedicated support team and regular meetings. MESH and PDS is still ongoing but the support does not appear as freely available”.


Finally, developers were asked to give NHS Digital an overall score, which averaged 3.78, up “from 3.0 and 2.3 in previous years”.

NHS Digital noted the general uptrend across all areas measured by the survey, but also that there remains a great deal of work to do to meet the needs of API consumers. The following areas of priority set out in response to the survey are:

  • increasing the number of APIs with consistent test data
  • giving developers access to API onboarding requirements upfront
  • including Node coding examples
  • clarifying “dependencies between APIs”

To learn more about the survey and its findings, please click here.