Open source in the NHS

There has been a lot of talk recently about the role of open source software (OSS) in the NHS and the govenment has recently published a procurement toolkit which aims to push the public sector towards procuring open source solution where possible.

Considering the role of OSS within healthcare, I think there are two distinct categories:

  1. Open source solutions which might be procured directly by the NHS.
  2. Open source components to facilitate building software for the NHS.

The first category is where recent discussions have focussed and includes things like operating systems, databases and healthcare-specific software such as the clinical portal released by Leeds recently. There are some very well established options here but uptake has been very limited so far, largely due to the well established dependency on Microsoft technology (which, until recently, has been licensed at a heavily discounted rate) and risk-averse procurement processes.

The second category is interesting because having open source components for NHS software both lowers the barrier to entry for new suppliers and also allows suppliers to concentrate on areas which deliver customer value. There is very little UK-specific tooling around standards such as HL7, ITK, Common User Interface, DM+D, SNOMED CT – suppliers spend a lot of time and money implementing internal tools to deal with these themslves. Why are there not open source projects in these areas? I think a large part of the problem is the lack of a visible, active healthcare-specific development community in the UK. As a supplier, why would invest in open sourcing one of your internal projects without confidence that the development community can extend and support that project in a more effective way than we can on your own?