I have been wondering about this sort of thing. I realise borgs has more knowledge than me in this area
but I am concerned about Microsoft having a monopoly on supplying OS systems to the NHS. I would be interested to see if it were possible to explore another option.
The NHS uses quite a bit of purpose made software. Where I work (the Out of Hours Service) we use Adastra http://www.advancedcomputersoftware.com
If Adastra could run on a free OS I think we could save quite a bit in licence fees. There wouldn’t even need to be retraining the OS (Windows) is just used to boot up and then open Adastra. Not sure how pleased the IT department would be though
The NHS can sometimes seem like a lot of fiercely defended fiefdoms
so suggesting at a National or Regional level might indeed get a better reception. I wonder if our friends in the Free Software Foundation could help?