A volunteer-led project to tailor the Linux open source operating system for use within the NHS has been axed after receiving a second trademark infringement letter threatening action from the Department of Health for breach of copyright.

Originally called NHSbuntu, later changed to NHoS (National Health Operating System) after an earlier legal warning, the open source project was being developed as a proof of concept based on the Linux Ubuntu distribution.

The project began in January 2017 trying to prove the potential to replace the current NHS Windows-based smartcard verification system, used by almost three-quarters of a million NHS staff.

The ultimate ambition was to provide an alternative to the Windows operating system, used in almost all parts of the NHS.

The volunteer initiative had attracted interest from a range of NHS organisations and meetings with NHS England.

The NHS, which spends approximately £100m a year on Microsoft licenses, is currently engaged in negotiations with Microsoft for an NHS-wide enterprise licensing deal.

The project initially ran into difficulties with the NHS brand police for its provocative use of the NHSBuntu name.  Following an initial warning the project was renamed NHoS (National Health Open Source). The change was not enough to satisfy the Department of Health further threat of legal action was sent to the project team this week.

The Government Legal Service letter required that NHoS “cease using the NHS letters in your website domain name, your organisation/ product name, your twitter account and the NHS logo in your organisation name and product logos”.

“With many public code repositories each with testing and packaging tools, changing the name of the project required significant work, all time and effort that could have been used to further develop the functionality of the project.” Dyke told Digital Health News.

For Dr Marcus Baw, co-founder of the NHoS project it was the final straw, he blogged “We’ve finally reached a point where we’ve had enough.”

Dr Baw continued: “The entire NHSbuntu/ NHoS team consists of four core members who have been working as volunteers, with a few small work packages and pieces of funding courtesy of the Apperta Foundation (a Community Interest Company set up to provide seed funding for NHS open source initiatives).”

He argued that the legal challenges would never have happened had NHS England or NHS Digital provided any support for the initiative.

“But we have received absolutely zero backing from those higher up in NHS Digital and other NHS bodies, – despite significant interest from grass-roots CIOs and NHS tech implementers, who welcome the range of possibilities that an open source NHS-warranted Spine environment would provide them.”

Dr Baw added: “The NHS will just have to solve its own terminal addition and lock-in to Microsoft. One day we may re-initiate the project, when we have some people backing us at high level who actually believe in the project’s aim and aren’t using it as leverage to hep them get their political ends.”

In a parting shot Dr Baw concluded his blog post: “You hear a lot about innovation in the NHS, but if this is the way innovators are treated – and with the full might of DH Legal against an unfunded volunteer organisation – then you can see why we have no actual innovation…”


Rob Dyke and Dr Marcus Baw, the two key members of the NHoS collaboration, are associate partners of Digital Health.  Rob Dyke consults on technology and architecture. Dr Baw, ‘discourse wrangler’ at large, has been a prime mover is the success of the online CCIO and CIO communities.