Digital public infrastructure (DPI) is the set of open standards and the shared components built on them that any public service or private company can use, in the same way a road network serves every vehicle. 

Its purpose is choice: giving institutions the capacity and agency to design and shape their own digital future, without becoming locked into a single system or supplier that isolates them and their patients from the system around them, or inheriting the choices of the supplier they started with. 

Open banking shows what this looks like in practice. A single published standard enabled firms to access account data across the major banks, with customer permission, while retaining the freedom to make their own technology decisions. This operating model has added an estimated £4 billion to the economy.

Health data infrastructure is not starting from scratch. Each nation already has a national patient identifier, ways to locate records, a patient login and widely used clinical vocabularies. What is missing are agreed standards for how these pieces and the systems around them should connect and a mechanism for ensuring consistency of implementation locally, regionally and nationally. Without them, each new integration is commissioned separately, usually through an external contract, and the NHS pays to solve the same problem again and again.

Nesta will work across the UK nations, engaging stakeholders and technology owners across health, technology and policy to set out those standards, test them in practice, and recommend a sustainable model for their adoption. We will engage patients and the wider public in design. The result will be a field-tested blueprint for DPI in health.

The next few years offer a rare opening to change long standing causes of digital disappointment. Major investments such as the Health Data Research Service and the single patient record are already committed. If flagship programmes like these are delivered through open standards, they can serve as an extensive foundation for a transformed digital care landscape.

AI also raises the stakes: tools - from ambient voice on wards to earlier disease detection - are only as good as the data beneath them and they work best where that data follows common standards.

Public expectations are rising too. People increasingly want to know where their health data is stored and who controls it, and open standards offer a clear way forward on  questions of digital sovereignty.

As an independent foundation with no system to sell, Nesta will bring experts together, test what works, and hand the findings back to the people who run those systems. Every decision-maker and buyer in the public sector wants to provide value for money and improve care, but the complicated landscape of proprietary offers little scope for them to do so. We want to change this.

We want every NHS organisation to have a real choice about the infrastructure it depends on.

That starts with openly published standards for how health data is held, described and shared. Those standards need to be used in practice and backed by components that any hospital, region or national programme can adopt, test, and replace without starting again.

If this works, data will follow the patient between services, and organisations will have more agency over how they can use, move, and share data. Suppliers will compete on the quality of what they offer rather than on the cost of leaving, and public money will be spent once on shared foundations instead of spending many times over to solve the same problems. The public will also be able to see how their data is being used.

This is a short, practical programme, run with the people already doing the work. It focuses on the components that health organisations run for their own benefit: the standards, software and governance that hold and handle their data. The aim is for local technology that doesn’t lock people in. Each component should work well where it is installed, be built once and adopted anywhere and connect with other sites when data needs to be shared for care, planning or research.

Between now and spring 2027 we will:

• map what already exists, including the standards, technology, governance and gaps, through published specifications, expert convening and an open call for evidence
• publish a draft blueprint for expert challenge
• test the proposed standards and components with NHS sites, to find out what it takes for systems built in different places to work together
• involve patients and the wider public in the principles behind the blueprint, so it reflects how people think their data should be used
• publish a final blueprint and roadmap with recommendations for adoption and a sustainable funding model

Everything we publish will be open: standards anyone can read, components anyone can adopt and findings that include what did not work.

This only works if the people who run, build and use health data in the UK take part. There are three ways you can get involved

Respond to the call for evidence

Opening in mid November, if you run, build or use health data across organisations, tell us what works, what doesn’t and what you would need. 

Bring a site or a component

If you have built something that moves health data between organisations, or hit the wall trying, we want to test it with you and publish what we find. 

Follow the work

Working papers, site findings and the final blueprint will be published as they are ready.  

To get involved, share something relevant you’ve worked on or be notified of future opportunities and updates, please contact us at [email protected]