Open source plans revealed

NHS England is looking to create a series of community interest companies to act as custodians for open source products introduced to the NHS.

NHS England revealed in mid-2013 that it wanted to encourage an open source option for trusts looking to invest in electronic patient record systems, and that some of the £260m ‘Safer Hospitals Safer Wards: Technology Fund’ would go towards this.

Last week, NHS England head of business systems Richard Jefferson told EHI that ten to 12 trusts are “seriously engaged in looking at a moderate-to-large open source EPR-type solution."

Another 15-20 are “tentatively engaged in discussions around their direction of travel” and Jefferson expects an announcement soon on preferred bidder status for an open source provider at one trust.

Trusts taking open source systems will receive services from a custodian that “effectively replaces a proprietary software vendor” by doing things like testing and code control. Trusts will continue to procure implementation and support services.

The CICs’ directors will include representatives from the user trusts and some independent directors, such as from NHS England. Jefferson said the details of how trusts will procure open source systems are still being finalised.

“We will be discussing this with trusts, but we are fairly certain we will create CICs to act as custodians, but the exact procurement route and whether it will be an existing framework or new, those are the things that will probably be another one to two months before being finalised,” he explained.

The idea is to have one CIC per product, which will give assurance to trusts that they “aren’t going it alone" and that "hey have the support of the CIC that will deliver on code control, scalability, reliability and safety of the products."

The CICs will also mean that “less technically able” trusts will be able to take advantage of open source. “It gives the same assurance as a proprietary vendor with the added benefits of transparency and the ability to get quicker changes through and see the code and share innovation between them,” said Jefferson.

He added that the CICs will develop over time to ensure proper safety controls are in place, starting with everyone being able to see the code and building up to provide certification for contribution to the code.

The US Department of Veterans Affairs developed the Open Source Electronic Health Record Agent as custodian of its open source EPR, VistA. 

Jefferson said that the services provided by the CICs will be similar at a high level to Osehra, but that the CICs will be more inwards focused on the NHS and more specific in terms of how their custodial services are commissioned.

The timescales associated with spending the first round of technology fund money mean the £20m earmarked for open source projects has been rolled over into the second fund. Details of how to apply for ‘tech fund2’ are due out at the end of this month.

“The ambition for tech fund2 is to be able to go with a number of large procurements of an EPR-type system so at [the Health and Care Innovation Expo] we’ll be running sessions on the process map of how we will go through a procurement and bring the delivery of these products to a trust,” explained Jefferson.

IMS Maxims and HP are each planning an open source offer for the NHS and work is ongoing to to anglicise VistA for the NHS market.

Jefferson said NHS England is talking to Tactix4 about its open source nursing observation system, and Moorfields Eye Hospital NHS Foundation Trust about its open source EPR Open Eyes. Northern Lincolnshire and Goole Hospitals NHS Foundation Trust is also speaking at the expo about a product it has developed.

NHS England will provide a specific definition of what qualifies as open source and the objectives of the open source programme. Broadly, the aim is to increase the availability of solutions for the NHS; encourage entrepreneurs and innovation; decrease timescales for system change; and reduce costs for the NHS.

There are a number of sessions on open source at the Innovation Expo in Manchester from 3-4 March starting with a seminar hosted by Jefferson at 10.45am on Monday. There is also a programme of speakers in the entrepreneur zone on Tuesday including IMS Maxims and Tactix4.