NHS: Dr Ian Lowry, ‘Going Digital – it’s not an island’


Biography: Dr Ian Lowry Programme Director Health and Social Care Information Centre (HSCIC), Leeds

Following an early career in the Merchant Navy, Ian Lowry graduated with a degree in Maritime Technology and PhD in mathematical modelling from Cardiff University. In 1991, he joined Lloyds Register as a junior Naval Architect. With the arrival the dot.com bubble, he decided there was an opportunity to concentrate on developing a career in Information technology. He joined Andersen Consulting and enjoyed a few challenging years working in their supply chain practice in Paris, specialising in the delivery of e-procurement and B2B solutions. In 2003, he joined the NHS to manage the design and delivery of a new Electronic Prescription Service for England.

This service has been delivered and is deployed to 25,000 GP and pharmacies across England and supports the transmission of 1.7 million prescriptions issued every working day. Today, Ian is responsible for the design and delivery of the next generation NHS Spine Service. The Spine is the national NHS infrastructure that supports a number of critical NHS Services for patients, healthcare professionals and the NHS.

This is an exciting programme of work using agile methodologies, open source technologies and noSQL databases to replace a legacy system that has been embedded within NHS business processes for the last 10 years. Going digital has not been without its challenges…….. Guru Lecture: Going Digital – It’s not an Island. In 2012, following some proof of concepts, Ian was given the challenge of leading the programme of work to replace the existing legacy NHS infrastructure (known affectionately as Spine) with the next generation NHS Spine Services.

The Spine is a collection of national applications, services and directories that support the NHS in the exchange of information across national and local NHS systems. The Spine connects clinicians, patients and local service providers throughout England to essential national services. The Spine is important to the NHS as it: Stores over 80 million patient demographic records in the Personal Demographics Service (PDS) to allow patients to be uniquely identified (via NHS Number) in the connected systems; Stores summarised clinical information for over 43 million patients which may be important for the patient’s future treatment and care, such as allergies, current medications and adverse reactions to drugs; Ensures the security of systems required to restrict access to the national and local systems.

On a normal working day, over 275,000 registered NHS Smartcard users access the Spine in support of patient care; Supports national applications such as Summary Care Record (SCR), Choose & Book (CAB), Electronic Prescription Service (EPS), GP2GP health record transfer, Secondary Uses Service (SUS) and NHS Number; and Connects and services more than 21,000 organisations and links over 27,000 ICT systems within these organisations, securely.

The challenge was to:

  • Establish an in-house software house to build NHS Spine Services using agile methodologies;
  • Follow Cabinet Office guidelines and use open source technologies;
  • Provide a better value for money proposition that the existing legacy service; Transition from Oracle to noSQL database technology and migrate 315m patients records securely; Stand up an E2E service operation function; Work collaboratively with the existing service provider to manage contract exit and assist transition;
  • Engage with 63 system suppliers, servicing 27,000 organisations that connect to NHS Spines Services on a daily basis to support 275,000 concurrent users;
  • Engage a large NHS user base and manage political expectations;
  • Assure the technical and clinical safety of the replacement service;
  • Deliver the replacement service before the legacy contract ends on 31st December 2014;
  • And ensure the transition to the new NHS Spine Service is seamless with no impact to patients, Healthcare professionals or the NHS.

Lecture: ‘Going Digital – it’s not an island’

This lecture draws upon the experience of delivering such a programme and what going digital meant for a large organisation delivering a critical national service. Recounting the good, the bad and the ugly should hopefully highlight there are many inter-connected parts that need to align with the operating environment to ensure success.