Accepted for/Published in: JMIR Human Factors
Date Submitted: Sep 12, 2024
Date Accepted: Jun 23, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital capability, open-source use, and interoperability standards within the NHS in England: A survey of healthcare trusts
ABSTRACT
Abstract Objective To document the capabilities and technologies used in the NHS to develop digital. Design The study was conducted using Freedom of Information (FOI) requests and systematic website searches. Data sources Data were collected via FOI requests to NHS trusts between July 2020 and July 2021. Technology searches were conducted between August 2020 and July 2021. Data collection/extraction methods Data were compiled from responses to the FOI request and technology websites. Results A total of 191 (84.5%) of the then 226 NHS trusts completed the FOI request and 161 of the 191 (84%) had software/app development, website, innovation teams. One hundred and twelve (70%) teams developed front facing service user websites/apps. One hundred and fifty (93%) worked with clinical staff to formulate innovative ideas. Fifty-five (34%) carried out developments for other trusts and external entities. Thirty-five (22%) had attempted to secure an innovation grant. One-Hundred and thirty-eight (86%) disclosed the technologies they use. A total of 84 technologies were identified: 28 programming languages, 19 frameworks, 10 libraries, 11 databases, 7 interoperability standards, 5 application programming interfaces / web services and 4 continuous integration / continuous deployment platforms. Twenty-five (16%) said they always used open-source technology and 9 (6%) said they used it sometimes. Twenty-four (15%) disclosed technologies referred to interoperability standards in their responses. Conclusions The NHS must adopt a cohesive strategy and refine policies to ensure the success of its digital, open-source technology, and interoperability standards initiatives. Summary What is already known on this topic? • Research findings have shown that NHS trusts and social care providers still lack digital maturity. What does this study add? • The study provides a comprehensive list of technologies used in National Health Service (NHS) trusts in England. It identifies that NHS trusts are highly capable of digital innovation but are not equally adopting open-source technologies. How this study might affect research, practice or policy • This study could help to guide digital policy regarding innovation and the use of open source within the NHS.
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