NHS England Genomics Order Management

Background

The NHS Genomic Medicine Service routes specialised genomic tests across England, integrating with hospital trusts, the seven Genomic Laboratory Hubs and the NHS England commissioning function. The Order Management System Core Broker is the central piece of infrastructure that brokers test orders between requesting clinicians and laboratories, handling routing, status, results return and audit.

NHS England commissioned an Alpha phase via Digital Outcomes 6 to validate the technical approach and scale of the system. PretaGov was awarded the contract starting 16 January 2024.

Solution

The Alpha was delivered in line with the GOV.UK Service Manual for Agile Delivery and the NHS API lifecycle. The technical work centred on modern API frameworks (FHIR for clinical data exchange) and the NHS England core services: PDS, ODS, NEMS, GPC, SPINE, NRL, NCR, and SNOMED for terminology.

We delivered the broker as a scalable cloud service with the data management and protection regulations that NHS England requires baked in, alongside a comprehensive testing and quality-assurance strategy. The codebase deliberately favoured low-technical-maintenance patterns: well-supported mainstream technology, type-checked Python, automated testing pipelines, infrastructure as code.

Outcome

The Alpha validated the broker architecture and produced working code, design assets, and a scaling plan ready for the Private Beta phase. The engagement also surfaced patterns useful across NHS England's broader API estate — particularly around FHIR integration and the practicalities of running NHS-grade APIs against the existing core-services landscape.