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On 1 April 2017, the BT-backed N3 secure broadband network for NHS customers closed to new customers, and the transition process onto the Health and Social Care Network (HSCN), many years in the planning, began in earnest.
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One of Europe’s largest virtual private networks (VPNs), N3 has a long and venerable service history going back a decade. It connects 1.3 million NHS staff and every GP, hospital and clinic in England and Scotland.
Since its inception, the NHS’ own statistics say it has saved the NHS nearly £1bn, and every day makes 39,000 hospital appointments, sends 675,000 electronic prescriptions, and transmits the equivalent of 150 billion printed A4 pages. It contains 12,000km of fibre, enough to stretch from London to Hawaii.
However, N3 is now showing signs of old age; it is slow, creaking and fraying around the edges. Many NHS customers have been itching to move off N3 for some time, a point driven home at the HSCN Summit in London at the start of April 2017.
“You can always argue change programmes could be done sooner, but people are at different stages,” said Pat Clark, HSCN programme director at NHS Digital.
“Had we done this a couple of years ago, some trusts may have been ready but not many. If we’d gone out without industry, it wouldn’t have worked at all. HSCN isn’t a like-for-like replacement. There is a lot of stuff to do.”
Learning from PSN
In many ways, the HSCN framework very much resembles the Public Services Network (PSN), which provides public sector customers with a market from which to pick and choose the network services mix that best suits their needs.
Like PSN, the objective is for HSCN to save money by enabling competition in the market to lower prices, add scale and efficiency by bringing in regional procurements, and trim excess networking capability, which may include levering local and regional PSNs to include it.
For HSCN’s designers, many of whom are veterans of the design and implementation of the PSN, the process of setting up the network framework has been somewhat like the birth of a second child – lessons have been learned from the first time around and the hope is that things will now run more smoothly.
Michael Bowyer, director at public sector ICT association Innopsis, a seasoned public sector networking specialist, said HSCN had taken everything that worked well from PSN.
“We didn’t chuck away all the hard work we did developing PSN – we took the relevant components that work in the market today and made them better,” Bowyer told Computer Weekly.
“That enabled us to achieve things far quicker than before because PSN started from nothing but HSCN has all the benefits of PSN, plus some tweaks.”
Clark at NHS Digital agreed there were many parallels between PSN and HSCN: “We are looking to move to a standards-based approach to networking, aligning with what industry already does.
“We didn’t want a bunch of standards that we assumed were right and issue that as fait accompli to the industry. We struck a balance between obligations to give us the assurance we needed that HSCN will be a robust and reliable network that industry can deploy easily and quickly,” he said.
Responding to previous criticisms, notably from supplier Capita – which in 2016 claimed many NHS Trusts were not ready or, in some cases, even aware of the imminent transition – Bowyer said there had been legitimate concerns about what would happen on 1 April, but that NHS Digital had put continuity of service at the forefront of all its planning.
“NHS Digital signed a transition network [TN] arrangement with BT and that TN contract provides the maximum flexibility required by NHS Digital,” he said.
“One of the good parts of that arrangement is that it provides very explicit obligations on BT to assist with new network connectivity as it starts to be deployed over the next few months.”
Dermot Ryan, fellow programme director at NHS Digital, added: “We have been engaging extensively with the NHS for the past year, warming them up to the fact that the existing agreements end in March.
“When you overlay on that the standards development work for industry, we’ve been warming them up fast to the fact that this is coming down the line.”
The next steps
The first HSCN compliant supplier was named on 3 April 2017 as MLL Telecom, which is a Marlow-based managed network services provider with customers including Suffolk County Council, Gateshead Council, the University of Wales, and Avon and Somerset Police.
NHS Digital said it was currently processing a number of other applications from suppliers that want to offer new services in the HSCN marketplace, with most expected to become compliant during May 2017.
Besides MLL these are AdEPT Telecom, BT, Convergence Group, Interoute, ITPS, Kcom, Level 3, OCSL, Piksel, Redcentric (which also holds the peering exchange contract for HSCN), Updata, and Virgin Media Business.
In June 2017, assuming all the listed suppliers make it through, a number of health and social care organisations will begin work on testing out elements of HSCN, using non-production systems and data while retaining TN as the prime front end.
NHS Digital will fire the starting pistol on these trials once a critical mass of suppliers have moved through the first stage of the compliance process to ensure HSCN is validated as ready for live, operational services. This will be the second stage of the compliance process, which will involve standing up a live HSCN circuit.
The organisations involved in the pilots include, but are not limited to, the Birmingham Children’s Hospital and Birmingham Women’s NHS Foundation Trusts; Hull and East Yorkshire NHS Trust; Devon Doctors, a network of private GPs; and retail chain Asda, which will test out links into its in-store opticians and pharmacies.
For other NHS organisations, the messaging from NHS Digital is to get started immediately. Laying out the timescales at the HSCN Summit, Clark said full-on procurements will begin this year.
“It’s important for us to get this market going. We’ve got a real challenge to migrate thousands of connections over the next two to three years, so it’s really important that the first stage is done efficiently and quickly,” he said.
Ian Fishwick, AdEPT Telecom
A big part of the reason why NHS Digital is so keen to get things moving at pace, according to Ian Fishwick, CEO of AdEPT Telecom, is because the organisation is on the hook for the TN costs as well.
Fishwick pointed out that now that Ofcom has introduced further regulation to bring down the cost of data circuits, a gigabit circuit today is cheaper than a megabit was back in 2012. “Most N3 circuits are less that 10Mbps, and there is no price for that now as we rarely bother selling it,” he said.
“No wonder NHS Digital want you off N3 as fast as possible as they are paying the bill. The cost of 100Mbps is down 55%, the cost of a gig is down 66%. Anybody who’s tempted to stay where they are is really missing the point.”
For any laggards, the messaging may seem decidedly worrying. Clark said procurement plans would need to be in place by the end of June 2017 at the very latest.
“There’s a lot of pressure to get off the existing infrastructure and we want you to be able to access these services as soon as possible,” he said. “It’s very difficult for us to do that if we don’t have an indication of what your procurement plan will be.”
However, if any organisations do not have a basic plan by 1 July 2017, they may still be able to go in with neighbouring organisations and join a regional procurement. They may also sign up to one of a number of centrally-managed aggregate or procurements which will be run on behalf of the NHS, as long as they state that intention as a clear part of their plan now.
“If you’ve not made your mind up, don’t think you will be in a position to plan a migration later this year – join an aggregate procurement,” said Clark.
NHS Digital’s own statistics currently suggest that collaboration will be the way forward for the majority. It claims 16% of organisations have indicated that they mean to obtain HSCN connectivity for themselves but not in collaboration at this stage; 40% mean to collaborate with other organisations in their area; and 44% have expressed a wish to join a centrally managed procurement.
The central capabilities of HSCN – interconnecting suppliers and enabling them to deploy live HSCN connectivity into the health and social care sector – are supposed to be in place by the autumn. However, Innopsis’ Bowyer said he expected to see the first wave of procurements coming out in the next few weeks.
He added that some “tactical” HSCN connections will very likely be set up imminently. “It makes sense that if someone wants a brand new circuit with no existing one, they should have access to HSCN, or where it’s economically prudent to buy connectivity below the procurement thresholds,” said Bowyer.
“Those sorts of things will come on board relatively quickly. Between now and the end of May, I wouldn’t be surprised if there were some of those tactical connections, where there’s a need.”
The last procurement of its kind?
Given that the Government Digital Service (GDS) is increasingly keen to emphasise that the internet should be “okay” for the vast majority of government work, Ryan at NHS Digital stressed that the transition to HSCN should not really be seen in the same light as the standard procurements of yore.
“This isn’t a massive procurement, it’s lots of small ones. HSCN is putting money in the pockets of customers and encouraging them to go to the market to buy services,” he said.
“The long view is to get applications onto the internet – we’re very much aligned with the government strategy that the internet is okay. That is something we’re committed to and we will work with GDS towards that view.”
Clark was more explicit still in his view that, unlike N3 or PSN, there was no date for HSCN going out of date.
“I don’t have an expectation about how regularly customers will go back to the market. The nice thing about this programme is that we never have to do it again, it is designed to naturally progress along the lines of user requirement and technology evolution,” he said.
“Flexibility is built in, we can sit down with industry and alter the standards to let the NHS exploit new technology.
“We’ve clearly got an approach and business case that is strongly supported system-wide – by NHS England, by the regional teams, by industry, by the Cabinet Office and by health and social care customers who see it as a real opportunity to do something more progressive. We don’t always have the luxury of that in government,” he said.
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