Rob and I do a detailed review of the - ‘two bottle of wine problem’ - NHSbuntu project which we built together back in 2017, relating how we used the great work already existing in the Linux and Open Source community to quickly put together a fully-functional, NHSmail-ready, stable, secure, legacy-app-friendly and low cost operating system for the NHS. With help from our friends (shout out to Brett Jackson, Cián Hughes, Rani Sen, NHS Spine Team, NHS Digital Delivery Centre, and others) we quickly had a working NHS Spine Identity Agent, and we virtualised/containerised anything that looked like it wasn’t fit to face the ravages of the internet. Then we got shut down. Here’s the story.

…There could have been a world in which QRISK3 was pre-installed on every desktop in the NHS instead of Minesweeper…

NHSbuntu website on GitHub Pages REBORN! pacharanero.github.io/www.nhsb…

Reveal.js slides from Digital Health Summer School 2017 at which I presented on NHSbuntu pacharanero.github.io/nhsbuntu…

NHoS Playing Nicely With NHS Apps

We even got them to give us an nhs.net email! nhsbuntu@nhs.net

NHSbuntu Identity Agent (GitHub fork) github.com/pacharanero/NHSbunt…

Brett Jackson’s YouTube video showing the NHS Identity Agent in action

NHSbuntu default settings repo github.com/pacharanero/nhsbunt…

NHSbuntu Livebuild repo github.com/pacharanero/nhsbunt…

Digital Health ‘NHS urged to consider Microsoft alternatives following cyber-attacks’ digitalhealth.net/2017/05/nhs-…

El Reg 'weaponised’ theregister.com/2017/06/30/nhs…

El Reg ‘we quit’ theregister.com/2018/01/18/nhs…

OpenHealthHub YouTube channel with various NHSbuntu videos youtube.com/@openhealthhub1142

YouTube Videos from the Community
sneekylinux - May 2017

Digital Health WannaCry digitalhealth.net/2017/05/nhs-…

Digital Health NHoS ‘We Quit’ digitalhealth.net/2018/01/nhos…

Our ‘Final Straw’ NHSbuntu post on OpenHealthHub openhealthhub.org/t/nhos-close…

Gemini’s summary of the NHSbuntu project

The NHSbuntu and NHoS (National Health Operating System) project was a significant grassroots, volunteer-led effort that captured the imagination of many in the UK's health tech community.1 Its story is as much about its technical ambition as it is about the challenges of working with large public institutions.

The project was largely driven by a small team of core volunteers, who were also health professionals and technologists, giving them a unique perspective on the challenges they were trying to solve.2

Dr. Marcus Baw: A General Practitioner (GP) and technologist, he was a co-founder of the project.3 Dr. Baw was a prominent voice in the open-source community and a "clinical informatician." He played a crucial role in advocating for the project's goals and was often the public face of the team, blogging and speaking about their work.

Rob Dyke: Described as the project's "ISO-master" and a technologist, Dyke was instrumental in the technical development of the operating system itself.4 He was responsible for building the custom Ubuntu distributions (ISOs) and working on key features like smart card integration.

Community: The project's developers actively fostered a community on platforms like openhealthhub.org, encouraging contributions from other IT staff, clinicians, and enthusiasts within the NHS.

The NHSbuntu/NHoS project began in early 2017, spurred by the need for a more secure, cost-effective, and flexible alternative to the NHS's heavily Microsoft-reliant IT infrastructure.7 The WannaCry cyber-attack in May 2017, which severely disrupted NHS services, highlighted the vulnerabilities the project aimed to solve, giving it a surge of public attention and support.8

In January 2018, the project was officially shut down.15 The developers, led by Dr. Baw, cited the constant legal threats and a lack of high-level support from key NHS bodies like NHS Digital as the reason for closing the project.

They felt they were being "used as leverage" in internal discussions about a new enterprise-wide agreement with Microsoft, and that despite interest from "grass-roots" IT staff, the higher echelons were not interested in backing an open-source alternative.16

The project remains an important case study in the challenges of introducing grassroots open-source initiatives into a large, politically sensitive, and highly bureaucratic public sector organization