Build with what already works. Why the best health tech plugs in.

I have spent twelve years working in NHS roles across clinical, innovation, health tech uptake and commissioning. In those twelve years, I have watched many promising health technology products fail not because they did not work, but because they tried to replace systems that were already working rather than connect to them.

The NHS does not need another data standard. It does not need another platform that requires wholesale adoption before it delivers value. It does not need health tech that asks the system to change around it.

It needs products that speak the language the system already uses. Products that fit into existing workflows. Products whose data arrives already formatted for the tools commissioners are already using. Products that add to the picture rather than demanding the picture be redrawn.

That principle shaped every data architecture decision we made at Nettie. And it led us to two systems that are already doing some of the most important work in physical activity data in England: Active Lives and OpenActive.

What Active Lives is doing and why it matters

Active Lives is Sport England's flagship measurement programme — the most comprehensive survey of adult physical activity levels in England, with approximately 180,000 respondents per year. It is an official government statistic, conducted by IPSOS, and it underpins investment decisions by Sport England, NHS England, local authorities, and national governing bodies.

The most recent Adult Survey covering November 2024 to November 2025 shows that 64.6% of adults are meeting the Chief Medical Officer's guidelines for physical activity — a new high. That is a significant and meaningful data point. It tells commissioners that population-level physical activity is improving.

But Active Lives has a specific, acknowledged limitation that is directly relevant to Nettie. Sport England's own research identifies that the primary challenge in capturing grassroots sport engagement is with un-ticketed events — particularly those with no point of entry, which includes playing for or attending a local sports team at small scale venues. Active Lives measures self-reported behaviour. A survey respondent says whether they attended sport events in the last twelve months. There is no verification. No timestamp. No proof. Just recall.

For the grassroots women's rugby match, the Saturday morning netball fixture, the women's cricket club that meets every week — Active Lives cannot capture what is actually happening. It can estimate. It cannot verify.

Active Lives tells commissioners how many people are getting active. Nettie tells them exactly which clubs in which communities are making it happen — and proves it.

What OpenActive is doing and why it matters

OpenActive is a national initiative run by the Open Data Institute and funded by Sport England that standardises how sports and physical activity data is published. Over fifty organisations currently publish OpenActive data, describing millions of activity sessions across England in a consistent, searchable format.

A landmark white paper from Sport England and the Open Data Institute — Data Infrastructure for a Healthy Nation — makes the case directly: by embedding OpenActive standards into digital health tools and local services, professionals can recommend trusted activities that support rehabilitation, mental health, and long-term conditions (Open Data Institute, 2025). The white paper calls for formal recognition of open data standards as part of national infrastructure and integration into NHS preventative health, social prescribing, and digital health pathways.

Physical inactivity costs the UK economy over £20 billion each year in healthcare costs and lost productivity (Open Data Institute, 2025). The OpenActive ecosystem is the infrastructure being built to address that. It is not a pilot programme or a startup idea. It is government-funded, professionally stewarded, and increasingly embedded in NHS thinking.

Nettie is built to be part of this ecosystem. Not to exist alongside it. Not to compete with it. To plug directly into it.

How Nettie aligns with both from day one

The data architecture decisions we made at Nettie were not made in isolation. They were made with Active Lives and OpenActive in mind, specifically to ensure that Nettie's data is immediately understandable and usable by the systems that commissioners are already using.

Every sport in Nettie's database is tagged with the OpenActive Activity List identifier — the canonical, machine-readable identifiers that OpenActive uses to classify every sport and physical activity. This means that when a commissioner pulls Nettie's attendance data, the sport classifications are already in a format that any OpenActive-compatible system can read without conversion.

Every club ground in Nettie's database is stored with GPS coordinates in decimal degree format, mapped to local authority geography using the ONS postcode lookup. This means that Nettie's attendance data can be cross-referenced directly with Active Lives data by local authority — the geographic unit Active Lives publishes at. A commissioner in Greater Manchester can compare Nettie's verified club-level attendance data against Active Lives' local authority-level participation estimates for the same geography, the same sport, and the same time period.

Every fixture timestamp is stored in ISO 8601 format — the international standard that both OpenActive and Active Lives use for date and time data. There is no conversion required. The data speaks the same language.

Why this matters for health tech adoption

The NHS has invested significantly in digital health infrastructure. It has also developed a well-documented wariness of health technology products that require the system to change around them rather than fitting into existing workflows.

Research into digital capability and interoperability standards within NHS England trusts found that disparities in digital maturity persisted across organisations, and that official guidance has continued to struggle to provide effective unification around data standards (Bennion et al., 2025). The organisations best positioned to succeed in NHS digital health are those that adopt existing standards rather than proposing new ones.

A 2025 roundtable convened by the Open Data Institute following the publication of Data Infrastructure for a Healthy Nation discussed the 10-Year Health Plan for England's emphasis on the NHS App as a vehicle for physical activity promotion. Participants expressed the view that OpenActive is well-positioned to support these objectives, with the potential for the NHS App to utilise OpenActive data to direct users towards community sport and fitness activities (Open Data Institute, 2025).

Nettie is positioned to be part of that infrastructure. Not as a disruptor. As a contributor. A source of verified, standardised, locally-grounded attendance data that fills the gap Active Lives cannot reach and plugs directly into the OpenActive ecosystem that Sport England and the NHS are already investing in.

The additive principle in health tech

The most successful health technology products in the NHS have almost always been additive rather than substitutive. They take data that already exists, format it in ways the system already understands, and make the picture more complete rather than asking the system to start again.

Active Lives gives commissioners a population-level view of physical activity. OpenActive gives them a searchable database of available sessions. Nettie gives them something neither can provide: verified, timestamped, club-level attendance data for the grassroots sport that is already happening in their communities, formatted to align with the standards they already use.

The question a commissioner has to ask about any new data product is: does this require me to change how I work, or does it make what I already do more complete? Nettie's answer is the second one. The data arrives already formatted for the tools you are already using. The classifications are already the ones you already recognise. The geography is already mapped to the units you already report in.

You do not adopt Nettie instead of Active Lives. You use Nettie alongside Active Lives, and suddenly the picture you have been trying to build for years gets a layer it was always missing.

The best health tech does not ask the system to change. It fills the gap the system already knows it has.

If you work in NHS commissioning, health data infrastructure, Sport England, or digital health — and you think there is a conversation worth having here — I would love to talk.

Nic Vovk Founder, Nettie nettie.online