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Modernising Government

Better public services tailored to the needs of the citizen and business, as envisaged in the Government's UK online strategy, require the seamless flow of information across government. The e-Government Interoperability Framework (e-GIF) sets out the government's technical policies and specifications for achieving interoperability and information systems coherence across the public sector. The e-GIF defines the essential pre-requisites for joined-up and web enabled government.

The e-GIF is a fundamental Framework Policy for the e-Government Strategy (April 2000). The Department of Health responded with the Department of Health e-Business Strategy (Nov 2001).

Specific goals were set in the Government's Modernising Government White Paper (March 1999), including:

These themes are reflected in the NHS Plan and the Government's Information Management and Technology Strategy for the NHS, described in "Building The Information Core" (Jan 2001) and "Delivering IT in the NHS" (Jun 2002).

Main features of the e-GIF

The main thrust of the Framework is the adoption of Internet and World Wide Web Standards. There is a strategic decision to adopt eXtensible Markup Language (XML) and the eXtensible Style Sheet Language (XSL) as the core standards for data integration and presentation. This includes the definition and central provision (i.e. by the Office of the e-Envoy in consultation with public sector bodies including the NHS) of XML schemas for use throughout the public sector.

Policies and Standards of the e-GIF cover four key areas. At the highest level complying with the e-GIF means [e-GIF version 4.1 part 1, section 4.3]:

The NHS response

In the keynote speech at the NHSIA Conference in November 2000 the Minister for Health stated "Many of the technical standards are already being agreed across the public sector as part of e-government, and we will adopt these standards for the NHS"

The NHS Technical Standards sub-Board endorsed the e-GIF on 23 November 2000, and relevant e-GIF standards are included in STEP (the NHS Standards Enforcement in Procurement process) and the NHS IM&T Standards Handbook.

The Office of the e-Envoy is the lead authority for implementing and maintaining the framework, in collaboration with departments, local authorities and other public sector bodies. The NHS Information Authority works closely with the Office of the e-Envoy on the development of the e-GIF and associated schemas and data standards (see http://www.govtalk.gov.uk).

Where the e-GIF applies

The e-GIF is mandatory for exchanges of information and interactions between NHS organisations; between NHS and other organisations; and between the NHS and the citizen. [ref: e-GIF version 4.1 Part 1 1.8, 1.10]

The e-GIF is not mandated for exchanges of information and interactions entirely within an individual NHS organisation, regardless of whether these are between separate systems within the organisation or between separate sites that may be geographically distant from each other. However, the use of e-GIF standards is recommended [ref: e-GIF version 4.1, para 1.11] for such exchanges. Note should also be taken of the principles of the electronic service delivery policy and public accountability: if the information is made available, or should be made available, outside the organisation, then it should be accessible (if practical) electronically, and e-GIF standards are mandatory in that context.

NHS organisation in this context means any organisation or individual delivering an NHS service. This includes (but is not necessarily limited to):

While the e-GIF cannot be arbitrarily imposed on non-NHS organisations or individuals [ref: e-GIF version4.1, para 1.9] any service agreements or contracts for NHS services must specify that relevant NHS and e-GIF standards must be used.

"Citizen" in this context means any user or recipient of NHS services - including patients and their relatives, formal and informal carers, and staff. It should be noted however that there is no obligation or requirement for citizens to use electronic services; they must however be offered as an option where this is appropriate and in accord with their wishes, and where offered they must use appropriate e-GIF standards.

New & legacy systems

Wherever the NHS is developing or procuring a new system, the test is "does this system have an interaction with citizens, another government or NHS agency, or a private sector organisation?" If the answer is "yes", that interaction must use appropriate e-GIF standards.

Similarly, where there is an existing legacy system, the same test applies, and again, if the answer is "yes", it must use appropriate e-GIF standards.

(If the answer to either of the above is "no", then there is a supplementary test of "should it" in order to comply with electronic service delivery targets - see the Department of Health e-Business Strategy.)

Business case for the e-GIF

The adoption of e-GIF standards is not a business goal in its own right. The e-GIF is a framework to support and enable the electronic delivery of public services, which forms part of the business strategy and information strategy of every NHS organisation. (Information for Health, published in 1998, updated by Building the Information Core, published 2001, required local health communities to develop and maintain local implementation strategies.)

As with any business investment or organisational change, the adoption of e-GIF standards must form part of an agreed information strategy with a robust business case, that assess the risks and benefits, and not least the affordability in money and resource costs of doing it. Changes to NHS information systems, more than other public sector organisations, are further constrained by major issues such as patient safety, health outcomes, and confidentiality and consent. This does not obviate the NHS adopting the e-GIF, but does indicate some of the additional factors to be considered.

Complying with the e-GIF

New NHS systems should be developed to comply with the e-GIF specifications in force on the day approval is given to the business case. Compliance with the e-GIF is one of the criteria that will be used when assessing and evaluating e-business strategies and deciding on the release of funding.

For implementations where there is a service contract with a supplier the user should specify the version of the e-GIF (and related standards) which will apply, and how to maintain compatibility with the e-GIF as it evolves. For systems developed "in-house" similar provisions will need to be incorporated into the implementation and maintenance plans.

The NHS Information Authority and National Programme for IT in the NHS work closely with the Office of the e-Envoy to ensure that NHS standards are consistent with the e-GIF.

Implementers of NHS information systems should note however, that:

Timescales for complying with the e-GIF

Legacy NHS systems that fall within the e-GIF mandate (i.e. communicating with organisations and systems outside their own organisational boundary) will need to provide interfaces that comply with the specifications or equivalents within the following timescales:

For systems that are part of meeting NHS Electronic Service Delivery targets (see the Department of Health e-Business Strategy) the timetables for meeting those targets will be acceptable

For systems that need to link to UK Online and the Knowledge Network, the timetable for making those connections will be acceptable

The e-GIF and the National Programme for IT in the NHS

NHS colleagues will be well aware of the National Programme for IT in the NHS. The use of e-GIF standards for interoperability is fundamental to the National Programme. Systems developed and implemented as part of the programme will necessarily be compliant with NHS standards (see, for example, the National specification for Integrated Care Records Service) and the architecture defined by the Design Authority within the programme and will, therefore, be e-GIF compliant.