In theory Health IT standards can be developed by anyone. In practice, most standards are developed internationally either by publicly sponsored organisations or supplier consortia. The English NHS and social care is represented in the publicly sponsored bodies (ISO and CEN) through the British Standards Institution IST/35 health informatics committee. The Health & Social Care Information Centre also participates in the development of other standards through membership of the various bodies, including GS1 and HL7.

While data standards may travel well, this is not necessarily as true for information standards. How they are used is not as common across international boundaries. For example, an English speaking patient does not require a translator in England but would do in France. This means that while information standards can be drawn from international work they must still be tested locally. There needs to be a strategy of adopt, adapt, improve. This tends to mean that information standards are developed at a UK or England level.

While anything could be an information standard, in practice there are some areas that are more important than others. The development of information standards must be led by national policy and clinical practice in order that there is an appropriate mandate. Standards therefore are likely to come from the following areas:

• Department of Health.
• NHS England
• Public Health England
• UK Terminology Centre.
• National Institute for Health and Care Excellence.

There are also key building blocks required to deliver more complex IT. An example would be the dictionary of medicines and devices (dm+d). Such standards will be produced by the Information Standards Delivery function within the Health & Social Care Information Centre.