- A curated, un-awesomelist of Missing NHS, Healthcare and Social Care interfaces, services, registers, and data sources.
- This is a 'partner' list to the Awesome Healthcare list https://github.com/kakoni/awesome-healthcare here I'm focusing on what's needed but conspicuously absent.
- 'Gravatar' for patient photos
- 'KeyBase' for clinical staff
- Ambulance Booking API
- National Consent Platform
- REST API wrapper over the NHS E-Referral Service
- REST API wrapper over the NHS E-Prescriptions Service
- National Poisons Information Service (TOXBASE) as a REST API to allow embedding into clinical applications.
- Electronic Staff Record API
- GMC Register API - get information about practicing doctors programmatically, including information about specialist status. Real-time confirmation of current valid registration.
- NMC number API - get information about practicing nurses and midwives programmatically
- BCAP Register (counselling and psychotherapy) API
- Physios and other Musculoskeletal Therapists Register API
- Social worker registration API
- Speech and language therapists API
- The NHS lacks robust communications tools which can be relied upon in times of crisis. For example, during the COVID pandemic it became apparent that existing mechanisms for contacting clinical staff by email are completely tied to affiliations to 'home organisations' - meaning that sessional, locum, and bank workers (who don't necessarily have a home organisation) are completely inaccessible by the system.
- NHSmail is still not reliable enough and is still heavily tied to Microsoft ecosystem making it difficult to use on certain operating systems.
- There is no reliable instant messaging system that is ubiquitously available in the NHS (apart from WhatsApp and other proprietary commercial offerings)
- 'Bleeps' (radio pagers) will continue to be heavily reliad upon because of their robustness and proven reliability. Replacing bleeps with other solutions can only happen when there is a suitably tested, reliable and robust ubiquitous replacement. Having a different IM solution in every hospital and CCG is counterproductive.
- Bleeps also represent a role, responsibility or service rather than a person, e.g 'the on-call Medical Registrar', they are handed over between shifts and represent a single and unchanging point of contact for expert help and advice without the need to know the expert's identity. Any IM replacement should replicate this functionality.
- Ubiquitous, versatile e-Rostering platform for staff rotas, with rota and on-call lists available via API to allow other applications to be aware of the current on-call clinician for a speciality, with appropriate fall-backs. Having that information available as an API is an important upstream dependency for a lot of useful services in automatic referral, time-saving features in EPRs (eg automatic selection of the correct consultant team for test ordering), and bleep replacement.
- ODS Code API (this now exists following work by Matt Stibbs and Tony Yates to build openODS)
- See also wardle/clods "A web service and set of tools for manipulating UK health and care organisational data together with supporting data such as geographical datasets from the ONS (e.g. the NHS postcode directory)"
- GP Practices register API
- Pharmacies register API
- Independent care providers API
- Care Homes register API - UUID of the care home & providing details of the type of care available, capacity, current availability, and facilities.
- MapIt by MySociety simplifies the use of geospatial information and enables easy creation of map layers or overlays reflecting open data and administrative boundaries
- Layer: CCG Boundaries
- Layer: GP Practice Boundaries
- Layer: Mapping of open data about ‘X’ health condition
- Layer: Location of GP practices
- Layer: Location of Hospitals
- Location of Urgent Care Centres
- comprehensive, clinically assured, clinical calculation APIs
- there are thousands of clinical assessment tools which we use to help make clinical decisions
- these should all be available behind validated, clinically-assured APIs
- this would improve the availability of these tools
- comprehensive, clinically assured, clinical decision support API
- building these as APIs creates a 'library' of clinical support which developers can easily add to their applications
- without such service APIs, the clinical and technical assurance required to add them becomes too much.
- (how many websites had mapping before Google Maps? yet how easy is it to add a map now?)
- Also, when systems have to implement all these calculations separately and repeatedly and at huge expense - it is hugely wasteful. The eventual end payer for health tech is the patient (whether as taxpayer in a public service, or directly in a private service), and we can provide better value by doing these things once and sharing it.
- These are things that can only really sensibly be done by 'the NHS' centrally (as opposed to by third parties):
- Open source cross-platform Identity Agent (for NHS SmartCard use) as interim step until smartcards are deprecated.
- NHS Staff Identity needs to be solved with a system that:
- works on any device / cross platform
- modern, instantly deployable, no hardware item to physically issue (cf VPN tokens and smartcards)
- has concept of temporary staff and multiple roles completely baked in
- enables detailed role based access control ('RBAC') and legitimate current relationship ('LR', I've added the current) management
- does not centralise changes of permissioning within an IT office which is closed during most of the NHS' working week (changes of permission need to be able to be authorised by supervising clinicians and ratified later)
- Full implementation of the NHS Spine 'Warranted Environment' in open source (this was the aim of the NHSbuntu/NHoS project)
- Client libraries and proper documentation for all Spine services. Why aren't suppliers sharing the client libraries they develop?
- REST wrapper for all Spine services, doing the hard work to make it simple. The madness of CDA, HL7 and MESH needs to be hidden from view. (this work is in progress here)
- NHS Common User Interface (or the good bits of it) implemented as a CSS-class-based web UI framework that can be dropped into new or existing web applications, lending them an instant UI which is ready clinically-, usability- and accessibility-tested.
- The NHS Frontend Framework admirably shows how this works in practice, but their focus is in creating nice, accessible, NHS websites. We need to take this principle and start sharing the UI components of good clinical software.
- Family Tree Diagrams as a parsable markdown dialect
- 'off the shelf' Anatomical and Body Structure diagrams that can be embedded into clinical systems, with terminology bindings which allow SNOMED-CT Body Structure codes (and other terminologies) to be chosen by clicking on the diagrams.
- Embeddable standard components for:
- SNOMED-CT code selection
- e-Prescribing
- NEWS2 and other forms of Early Warning Score
- SNOMED-CT has been chosen as the standardising terminology to be used across all of the NHS.
- Open Source Terminology servers for SNOMED-CT do exist: https://github.com/wardle/hermes
- However this is only part of the story. To use codes to do useful things you will need access to open, shareable, versioned, curated, and clinically-validated lists of codes which are suitable for identifying patients with, for example hypertension, or any other clinical condition. These conditions may be recorded in an electronic health record using a number of different SNOMED-CT codes, so you need a list of those codes that (for a specific use-case) should indicate presence of the condition you are interested in. Lists of codes are not currently chared in any specific format. The openSAFELY project is addressing this by developing and sharing open codelists, but more work is needed in order to have a full suite of open codelists.
- NHS PC Benchmarking - a downloadable open source software agent which benchmarks the PC being used and reports back to a central authority via web on: installed OS, patch level, RAM, CPU, disk, installed software, network bandwidth, and other information that would help national IT resources to be distributed in the most effective way possible.
- NHS staff undergo regular (usually annual) retraining on topics such as:
- Child and Adult Safeguarding
- Infection Control and Hand Hygiene
- Lifting and Handling
- Information Governance and Computer Security
- At present this is usually provided through a series of proprietary online training modules, often of very low quality, and provided by a number of private companies at at least moderate taxpayer expense. The content for the platforms has quite often been originally provided (in some convoluted way eg a 'partnership') by NHS staff themselves and therefore paid for by UK taxes.
- The requirement for a simple, high-quality, modern e-Learning platform for the NHS would be relatively easy to fulfil compared to some of the other awesomely-missing things on this list, and would save considerable money.