The Case for NHS-Owned, Open Software

Why It Matters

Restoring an NHS open‑source strategy would lower procurement costs, accelerate innovation, and ensure publicly funded software remains a shared national asset.

Key Takeaways

• NHS open‑source policy pages vanished after NHSX merger.
• Current NHS practice ignores gov.uk mandate for public code.
• In‑house development could cut costs and foster reusable software.
• Past open‑source program dismantled; funding misused by foundation.
• A modest 1% fund could seed sustainable NHS open‑source tools.

Summary

The episode of Digital Health Unplugged focuses on the NHS’s retreat from a publicly documented open‑source policy, highlighted by the sudden disappearance of policy pages after the NHSX merger into NHS England. Host Jordan Soloff and GP‑turned‑digital‑health advocate Marcus Bore explore why the removal matters and what it reveals about the current state of software development in the UK health system.

Bore argues that the NHS is flouting the government‑wide service standards that require all publicly funded code to be open source. He points out that the website cleanup was a “placeholder response” that failed to redirect users to the relevant gov.uk guidance, suggesting a deeper institutional reluctance. The discussion also covers the inefficiencies of outsourcing to vendors like KOS and IBM, where profit margins inflate costs and lock the NHS into proprietary solutions.

Key anecdotes illustrate the missed opportunities: the dismantling of the 2015 NHS Open‑Source Programme, the misallocation of half‑a‑million pounds to the now‑defunct Aperta Foundation, and the “1% campaign” that proposed earmarking a small slice of procurement budgets for open‑source development. Bore cites a patient administration system as low‑hanging fruit that could be rebuilt openly, gaining traction across trusts and creating a self‑sustaining ecosystem.

If the NHS were to adopt a clear open‑source mandate, invest in in‑house development teams, and allocate even a modest 1% of procurement spend to open‑source projects, it could dramatically reduce costs, avoid vendor lock‑in, and foster a collaborative software commons that benefits every trust. Leadership commitment and transparent policy links are essential to revive the momentum that once existed.

Original Description

In this episode of Digital Health Unplugged, Marcus Baw, a GP, clinical safety officer, clinical informatician and software engineer, calls for a rethink of NHS technology strategy, arguing that the service has drifted away from open source and in-house capability.

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