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National Imaging Registry roadmap

The National Imaging Registry (NIR) provides a national service for federated discovery and retrieval of diagnostic imaging, enabling clinicians to access imaging and reports across NHS organisations in real time.

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Roadmap

Completed phase

Alpha 2024 to 2025
  • prototype testing with suppliers and early imaging networks
  • functions include discovery of imaging records, report retrieval, and early peer-to-peer image sharing

Current phase

Beta 2025 to 2026
  • expansion to 5 to 7 imaging networks across diverse settings
  • live testing of interoperability of all Integrating the Healthcare Enterprise – Cross‑Community Access (IHE XCA) standards
  • pilot use cases in radiology
  • updated Data Sharing Agreement and Data Protection Impact Assessment (DPIA)

Next phase

Full rollout 2026 to 2027
  • expansion into more modern Mobile access to Health Documents (MHDS) technologies
  • supplier integration of Web Access to DICOM Objects – RESTful Services (WADO-RS) endpoints for modern imaging retrieval
  • national deployment across all imaging networks
  • full benefits realisation: reduced duplicate scans, improved Multidisciplinary Team (MDT) workflows, cost savings from Image Exchange Portal (IEP) reduction, and measurable patient safety and experience improvements
  • transition to Business as Usual (BAU) service support with defined Service Level Agreements (SLA)

Technical milestones

Now

  1. Implement functionality to enable clients compliant with Cross-Community Access (XCA) to discover and retrieve clinical documents from federated responding gateways plus enable go live.
  2. Implements RAD-75 (an IHE Radiology transaction delivered by Web Access to DICOM Objects – Web Services (WADO-WS)) allowing clients to retrieve imaging data based on previously discovered imaging manifests.
  3. Uplift service SLA To Gold level.
  4. Enhance interoperability with newer consumer technologies by introducing MHDS-compliant querying capabilities, enabling clients to query and retrieve clinical documents using Fast Healthcare Interoperability Resources (FHIR)-based methods.
  5. Support direct retrieval of documents from FHIR repositories, accommodating both native FHIR requests and adapted IHE retrieval requests. This ensures broad compatibility with existing systems and modern FHIR-based consumers.
  6. Extend querying capabilities by enabling clients to query the central FHIR registry (National Record Locator (NRL)) in conjunction with existing Cross‑Enterprise Document Sharing (XDS) registries to enable document discovery, supporting both legacy XDS-based and modern MHDS-compliant client systems seamlessly.

Next

  1. Introduce document registration capabilities specifically for MHDS-compliant producers, providing a standardised, FHIR-based endpoint for submitting clinical and imaging documents to the NIR solution, and utilising the NRL as the centralised registry.
  2. Enable retrieval of imaging data using WADO-RS (Web Access to DICOM Objects – RESTful Services). This transition enhances performance, aligns with current standards, and broadens compatibility with web-native and lightweight clients.
  3. Enable legacy XDS repositories to directly integrate with NIR by allowing them to register documents into the central FHIR-based registry, facilitating a transition from federated XDS registry infrastructure to a unified MHDS-compliant architecture.

Future plans

  • enhance interoperability with newer MHDS technology
  • expand to other diagnostic domains (for example, pathology, ophthalmology) beyond radiology
  • establish a national onboarding toolkit for trusts and imaging networks
  • integrate with wider NHS interoperability services (for example, Shared Care Records)

API documentation

The NIR uses API-based interactions, aligned to NHS England's internet-first and public-cloud-first principles. It supports RESTful APIs, FHIR, IHE XCA/XDS, and DICOMweb (WADO-RS/WS).

Learn how to write and publish API documentation for RESTful APIs on the NHS England API platform.

Further information

internal National Imaging Registry

The National Imaging Registry (NIR) allows for the sharing of imaging data across clinical organisations.

internal National Imaging Registry API

Use this API to access patient imaging records across NHS and private healthcare networks. The National Imaging Registry (NIR) API allows authorised systems to view a patient’s imaging history, including examinations, diagnostic reports, and imaging studies.

Last edited: 23 February 2026 2:43 pm