I attended a presentation of SPINE2 from CfH at Intellect today. I think it’s the first thing from CfH to really excite me (at least in a positive way) since they were established. While I’m reminded of “The Second Coming of the Great Prophet Zarquon”, who fans of Douglas Adams will remember only managed to get this in just before the end of the universe.
I have been hearing reliable rumours for some time about skunkworks activity within in CfH to try and re-implement SPINE (at least as used, rather than as specified) using open source components and an agile development methodology, but today was the first official confirmation of this. It would seem that the initial skunkworks proved the concept and has been thrown away, a great example of the value of a “fail-fast” philosophy, and that this has been followed by a second phase of the project which appears to be close to delivering a production version of SPINE2. I’m reliable informed that the initial skunkworks involved just a handful of people within CfH with a cost of under £250k. The next phase of the project has been support by some external development resource procured under G-Cloud from BJSS (www.bjss.co.uk) and while I don’t know how much this cost I think it pretty clear that it will have been only a tiny fraction of what it must have cost to get SPINE1 to the same stage.
If we are to believe what the SPINE2 Team told us– And I’m inclined to do so, because they spoke with obvious conviction and it tallies with other intelligence – this project is going to be a game changer for NHS IT. It will create lots of new opportunities for those in supplier community who can embrace new ways of working, has a much better chance of delivering what the NHS needs while providing a nasty surprise for those on both the customer and supplier side of the fence who have built empires and companies on bloated ways of working.
There are two key features of this project which I find very encouraging and I think are the basis of its’ likely success. The first is extensive use of proven open source components and the second the adoption of agile technologies. These together drive down development cost and risk and provide a much more responsive and flexible approach than traditional waterfall methods (for a light-hearted view of this see http://handihealth.org/handi-out-of-hours/ ) Add to this the use the project has made of G-Cloud to simplify the procurement of external resource and you have a much more responsive approach all round.
The team made some interesting comments. The first that they would be able to provide a copy of SPINE2 on a DVD that would allow suppliers to have their own test environment that they could run on a laptop, this will be a great help to developers. The second was that they had the capability to open up code and new interfaces which could potential provide a much easier route for third parties to interface to SPINE. This step would not be welcomed by some suppliers who businesses are built on their knowledge of and access to existing interfaces and the CfH team made it clear that no decision had be made to do this. However, while there have been previous promises from other parts of CfH that they would not do anything to undermine the business models of those who had invested heavily in interfacing to SPINE1, I don’t believe that it is the business of NHS to protect outdated ways of working and hope that a decision to open up SPINE2 to the maximum extent possible is taken. I for one would like to see the source code of SPINE 2 freely available on GitHub https://github.com/ and when I asked if this was a possibility I got a positive answer.
The slides of the presentations will be available to Intellect members shortly and I will include a link to these here as soon as I have it. I will also explore if these can be made publicly available.
This project could provide a new model for deliver NHS IT and deserves further development. My initial reaction is that I would like to see more of the work outsourced to the private and third sector, as I don’t think a return to in-house development on a wide scale is a great idea, but I think this project provides a great basis for a move to a more responsive, better value approaches built on an open and agile philosophy.
Finally, I’m encouraged because I think this approach fits with other ideas I’ve been promoting around GPSoC and the potential role for an ESB (which is fundamentally what is at the core of SPINE) See here for my blog “An ESB for GPSoC Phase 2 ?”