Making integration easier at the NHS

Tony Heap, lead product owner for API management at NHS Digital, explains how their new API platform is making integration easier for people building healthcare software.

At NHS Digital, we believe in the potential of digital technologies to improve health and care services – to give healthcare professionals and patients access to the information they need, whenever and wherever they need it.

To achieve this level of integrated care, we need point-of-care systems to talk to one another and also to our national systems. We call this interoperability.

This interoperability happens through APIs (Application Programming Interfaces). If we can build the right APIs, and make them easy to use, we can create a competitive marketplace of healthcare software that gives professionals and patients more choice and better value for money.

APIs have always been central to our strategy at NHS Digital – they are the primary method of access to our core national services, such as the Personal Demographics Service (PDS), the Electronic Prescription Service (EPS) and the Summary Care Record (SCR). We handle over 1.5 billion API transactions per month.

The challenge

Back in 2019, we identified a problem. People building healthcare software told us that integration was hard work, time consuming and costly. We discovered pain points all the way through the software delivery lifecycle, including poor documentation, out-of-date technology, tricky to access path-to-live environments, overly complex and manual assurance processes and patchy help and support.

These create a barrier to entry for newcomers to the healthcare software market, resulting in limited choice and higher costs for end users.

Our mission

Based on these pain points, we set ourselves a mission – to make integration easier. We also developed a set of supporting principles:

• make learning easier – with API documentation that is online, accessible and clear
• make design and build easier – with APIs that are internet-facing and that use modern open standards such as REST, FHIR, OAS and OAuth 2.0
• make testing easier – with sandboxes and test environments that are self-service and well-documented
• make onboarding easier – by only asking for things that are needed
• make help and support easier – with a single point of contact for support that is simple and reliable
• make building and running APIs easier – for our own delivery teams, with an API platform that is cloud-based and self-service, and support and guidance from our central team

What we have done so far

To achieve our mission, we’ve built the NHS Digital API platform – a one-stop shop for all our APIs, providing a consistent experience for API consumers and API producers alike.

A key part of the platform is the developer hub, where developers, architects, product owners, business analysts and delivery leads can come to learn about our APIs, try them out and register for full access online. We’ve put a lot of effort into streamlining the onboarding process.

To demonstrate what a good API looks like, we’ve also built an exemplar API – the Personal Demographics Service (PDS) FHIR API. This can be used to discover a patient’s NHS number, look up their personal details and update their record.

Finally, we’ve migrated a number of our other APIs to the platform. We currently have nine APIs in production, with eight more in alpha.

To date, we have handled over 1.6 billion transactions from 51 API consumers – some of which support apps that are part of the COVID-19 pandemic response. Our API catalogue includes 95 APIs and API standards.

We delivered the API platform using the GOV.UK agile delivery process – the gold standard for public sector digital delivery. We’ve tested the service with users frequently and made improvements based on their feedback. Also, developers can view, upvote, comment on and suggest improvements and features via our interactive product backlog.

This approach seems to have worked. When we first started, we conducted a survey which found that healthcare software developers rated their experience of integrating with our APIs at 2 out of 5. Two years on, the average is 4 out of 5.

We’ve also engaged with industry bodies – such as techUK and their Ten Point Plan for Healthtech – and thought leaders, some of whom had previously been outspoken about this area. They’ve been impressed by the improvements we’ve made, with one describing them as “an incredible move forward”.

Opening up the platform to third parties

Recently, we’ve made the API platform available to API producer teams outside NHS Digital. This is to allow others to take advantage of the work we’ve done and to move further towards a one-stop shop for healthcare APIs. This service is free as long as the use case is appropriate.

We’re excited about the possibilities this brings. We’ve recently been talking with the Ministry for Health in New Zealand, who have just started a similar journey to us. The team had seen our API platform and developer hub, liked what they saw and were keen to learn from our experiences.

What’s still to do

The API platform exited beta in late April, but that doesn’t mean we’ve stopped work. We’ll continue to improve the platform based on user feedback for as long as we can.

Our to-do list includes:

• continuing to migrate existing APIs to the new platform to make them easier to use
• proactively looking at what APIs are ‘missing’ from our portfolio
• improving the Digital Onboarding Service and migrating more APIs to it
• launching a developer forum
• iterating existing platform features based on user feedback

You can see a full list of our planned APIs and platform features on our interactive product backlog. You can also suggest, comment or vote on features you want to see.

Get involved

Ultimately, the purpose of our API platform is to improve health and care outcomes. We can’t do that alone – we need your help.

Firstly, we need to make sure we’ve built the right thing. So, give us your feedback – on the API platform and on the APIs we’ve built.

Secondly, we need our APIs to be used. So, take a look at our API catalogue and see whether any of them would be useful. In particular, get involved in a beta programme and help us to shape the future. In return, we’ll give you the ‘white gloves’ treatment.

Finally, if you have a health or care API that might be of interest to others, consider publishing it on our API platform.

We’re pleased with the progress we’ve made so far, especially with the overwhelmingly positive reaction we’ve had from our users. We’re looking forward to working with the health tech community to fully unlock the benefits of our API platform to further improve health and care.