How we're using Proxygen to transform API development

To deliver the NHS 10 Year Health Plan, we need a health and care system that’s joined up, patient-centred and data-driven. Services need to work together more seamlessly than ever.

But with thousands of NHS organisations using a patchwork of systems, joining up services is no small feat. APIs make this possible by enabling secure, real-time data sharing across systems.

As more NHS services move from analogue to digital, demand for APIs is growing fast. In fact, NHS API transactions surged by 270% in September 2025 compared to the same month in 2021.

NHS England’s API first policy has transformed the way national services are integrated across health and care. By designing systems that are built to connect, we’ve made it easier for the functionality of our national platforms to be embedded directly into the tools that are used every day by health and care professionals and patients. 

Running systems that are accessed millions of times by thousands of consuming applications means we need to make it straightforward for teams to connect in a way that is secure, reliable and consistent. To do this, we operate a national API platform that securely connects API producers and consumers and provides standard integrations with services such as identity authentication services. 

At the heart of this platform is the API proxy. Each API we support is fronted by a small piece of code — the proxy — which bridges the connection between the consumer and the producer, handling concerns such as authentication, security, traffic management and consistency.  

Historically, integrating health APIs with the API Platform experienced challenges such as: 

• teams needed a high level of technical knowledge to manually configure pipelines, repositories and proxies 
• the mix of tools like Apigee, Azure DevOps and AWS created extra complexity 
• heavy reliance on manual checklists made the process prone to errors and inconsistencies 
• repeated need for additional support was time-consuming, with integration averaging 12 weeks 
• inefficiencies resulted in reduced capacity for further innovation and development

Enter Proxygen - a product that creates and manages API proxies so teams don’t need to deal with the complexity of the underlying API platform. It ensures proxies are created in a consistent and secure way. 

It took us some time to realise that even a small piece of code, like a proxy, needed a product delivery mindset to create a service that could meet user needs.

Early challenges, including varied API design patterns, complex platform integrations and the need to balance automation with governance, meant the product had to evolve iteratively.  

Over time, as more teams piloted it and we incorporated their feedback, Proxygen grew from a basic automation tool into a stable, scalable and trusted workflow for API onboarding.  

It acts as a bridge between API producers (such as NHS services or third-party providers) and the API Platform. We built it and we maintain it, so we’re not reliant on a third-party provider.

Steps to building and onboarding APIs using Proxygen:

The EPS FHIR API team was among the first to adopt Proxygen, transforming how prescribing and dispensing endpoints are managed. Working closely with suppliers, they planned a smooth transition, developed new endpoints, and ensured clinical assurance through rigorous testing and supplier regression packs.

Switching to Proxygen has been a game-changer for API development. Teams now benefit from:

• faster debugging and clearer logging
• reduced latency and improved scalability
• less reliance on their central APIM team

The result? Faster delivery, better performance and APIs that are easier to maintain and support.

We’ve seen a sharp reduction in the average API development time from 12 weeks without Proxygen to just 3 to 4 weeks with it.

And, because API development teams are less reliant on our central APIM team, we can spread our support offer across more teams at once now. We help deliver more APIs, faster.

The EPS FHIR team’s successful move to Proxygen marks a major step forward in how NHS England supports API development. It’s a clear example of how the right tools can reduce complexity, speed up delivery and improve the quality of digital services.

By sharing this story, we hope to inspire others to adopt the Proxygen model and unlock similar benefits.

This shift supports our wider goals – improving user experience, reducing costs through smarter automation, and continuously raising the standard of our digital products to meet the evolving needs of the NHS.

If your team is still using manual processes to build and deploy APIs, now is the time to explore Proxygen. Contact us via Service Now - Raise a request with API Platform Service.