Introduction

This standard replaces General Practice Systems of Choice (GPSoC) requirements relating to integration and interoperability. It provides a single place for system suppliers to find out which interfaces they need to implement and to access the required documentation.

Future changes to interfaces will be communicated via the Roadmap.

Notes on quality and consistency of interface documentation

There are a large number of interfaces that GP systems need to implement. These interfaces, and their documentation, have been created over a very long period of time by a number of different organisations and programmes. The static nature of the GP systems market (no new entrants needing to implement) means that historically there has been limited justification and appetite for modernising or standardising existing documentation. This means that the format, quality and consistency of interface documentation is currently extremely variable.

Until these issues can be addressed suppliers and system implementers should expect to encounter issues with interface documentation. These could include:

• Inconsistencies in how optionality of requirements is expressed, e.g. MoSCoW ratings
• References to obsolete or outdated externalities, e.g. in-force legal frameworks, organisations or systems
• Descriptions of 'upcoming' or planned future phases which may or may not have actually occurred
• Broken links
• Referenced documents that have been included elsewhere in this standard rather than in the indicated location
• Referenced documents that interface owners have advised are no longer relevant
• Unavailable information relating to the impact of upcoming roadmap changes, e.g. where the replacement of existing VUA/OSA/LOSA based patient accounts by Nhs login could impact an interface implementation
• Verbose and/or difficult to follow documentation compared to modern best practices for interface documentation
• Unavailable sample files or test data

Suppliers should contact the NHS Digital team at gpitfutures@nhs.net to resolve any documentation issues which block them from delivering compliant implementations.

Interoperability principles

These interoperability principles are a SHOULD and suppliers are expected to adhere to them wherever possible.  Whilst adherence will not be assessed at onboarding, NHSD will expect any deviation from these principles to be supported by a valid rationale on delivery of interfaces.  NHSD may use adherence to these principles to guide decision making in circumstances of non-compliance or partial compliance against assured standards.

1. True interoperability (defined as the ability of two or systems to work together unchanged, even if they weren't designed to work together) rather than integration (change is required to make the systems connect) should be achieved wherever possible - Integration takes work, interoperability just works. Although the term interoperability is in widespread use within the NHS, what is meant is rarely well defined and the terms interoperability and integration are frequently used interchangeably. In our experience, the NHS uses a weak definition where two systems are said to be interoperable if they can exchange data in any way - even if that exchange is via a bespoke, point-to-point integration. True interoperability reduces the integration burden and allows systems to communicate more readily. 

2. Interoperability is more important than supporting customisation. Use the base definition of standards wherever possible. Extend only by addition and by exception. Do not view integration as a source of competitive advantage.

3. Use open design. The effectiveness of security components included in a Solution design should not be compromised by any visibility of that design, i.e. should not rely on obscurity.

4. Use open and government standards. Design systems up front to support information sharing. This covers both alignment with Open Standards and the use of Open APIs. Use open standards (including from outside healthcare), and common government platforms (eg GOV.UK, identity assurance, shared services) where available.

5. Make data open by default. Whilst minimising and securing personal data, or data restricted for national security reasons. Public data should be made available by default in both human and open machine-readable formats. Users should have access to, and control over how their own personal data is shared.

6. Use a common data model. Healthcare systems are connected in a many-to-many fashion. In this scenario, the use of a common data model ensures that each system only has to be able to translate to and from the common model and does not need system-specific knowledge of myriad other connected systems.

7. Messages should always be structured. Adding preformatted ‘human readable’ text or formats such as HTML to messages increases coupling with the source system and reduces the reusability of the message while increasing the risk of a system receiving inappropriate data which cannot be detected. Receiving systems are responsible for transforming structured message into appropriate formats (e.g. HTML, PDF or images etc.). It's always preferable to store the structured data and render to a display format on demand.

8. Interfaces must be system agnostic and semantically standardised. Systems must not expose their internal complexity and data structures on interfaces, nor should they expect systems they interface with to understand their internal data encodings and semantics.

9. Use decoupled integration patterns wherever possible. Decoupling should be achieved using appropriate integration patterns such as publish-subscribe and event-based architectures.

Interoperability non-functional requirements

The following overarching requirements apply to all interfaces in the scope of the Interoperability Standard which are offered by a Solution.    

Minimum non-functional requirements for interfaces built to the Authority's specifications

Where an interface/extract is built to the Authority's functional specifications, e.g. IM1 - Interface Mechanism, GP Connect the following requirements apply to the production implementation. For requirements relating to performance and availability suppliers should refer to the Service Level Agreement.

Capability-independent interoperability standards

This section lists the interoperability requirements which are not linked to single capabilities. These are typically (but not exclusively) supporting standards such as communications protocols or related technical standards.

Spine

The NHS Spine provides national interoperability infrastructure as well as specific national services, for example the Personal Demographics Service (PDS) listed further below under Dependencies. 

Two specific Spine components are key supporting standards for a number of the interop standards, and are listed multiple times within the 'Dependencies' column below. They are:

• External Interface Specification (EIS) describes how to connect to NHS Spine services 
• NHS Messaging Implementation Manual (MIM) describes the message formats used for Spine interactions

IM1 - Interface Mechanism

IM1 - Interface Mechanism is a mechanism for accessing data held in GP Systems (Systems providing one or more Capabilities as part of the GP IT Futures Framework). The interface mechanism facilitates three use-cases (Patient, Bulk and Practice) which are detailed within the IM1 page.

A system or application may wish to consume IM1 interfaces where they have a requirement to access data held in GP Systems.

A system or application is required to provide IM1 interfaces if ANY of the following are true:

• It offered IM1 interfaces under GPSoC
• It offers ALL Foundation capabilities under GP IT Futures

Authentication and authorisation

Standards for confirming the identity of service users and controlling their access to services or specific resources.

• Authentication and Access
• NHS login service

Communications

• Email (system accounts for automated sending for purposes such as notifications)

Generic FHIR Receiver 

• Generic FHIR Receiver (a component which will receive messages to the GP Practice)

Capability-specific interoperability standards

This section details the interoperability requirements which are associated with each Capability. 

Some interdependencies between individual interface standards exist. Creating a compliant implementation requires implementing all the required dependent interface standards, as detailed in the 'Dependencies' column.

Suppliers need to comply with all of the requirements that are associated with the Capability/Capabilities which the supplier is offering. 

Foundation Capabilities

Patient Information Maintenance

Recording Consultations

Appointments Management - GP

Prescribing

Referral Management

Resource Management

Non-foundation capabilities

Communication Management

Appointments Management - Citizen

Prescription Ordering – Citizen

View Record - Citizen

Digital Diagnostics

Communicate with Practice - Citizen

Capabilities to support new ways of working

Cross-organisation Appointment Booking

Unified Care Record

Medicines Verification

Medicines Optimisation

Deprecated Standards

• MIQUEST

Roadmap