On a typical working day, by the end of January 2007, the spine database, which forms the core of the NHS care records service (NHS CRS), was being accessed by around 50,000 authenticated unique users. And during the last full week of January 2007, the approximate volumes of messages processed in connection with the following systems and services were personal demographic service—six and a half million choose and book electronic booking service—over 1.4 million electronic transmission of prescriptions—half a million.
Growth in all these volumes is rising dramatically with the increase in functionality across the NHS CRS and continuing roll-out of the various elements of the system, but already the spine is the world's biggest structured health care messaging system.
It is not possible to provide a realistic estimate of what these volumes will be by the time substantial integration of health and social care information systems in England has been achieved by 2010. These will depend significantly on the way in which health care management and delivery processes in the NHS adapt and develop to reflect the enormous potential of the systems and services being delivered under the national programme for information technology.