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NHS Digital sets out Internet First policy

NHS Digital is soliciting input to its Internet First policy, a set of standards and guidelines to help health and social care organisations make digital services accessible over the internet

NHS Digital has set out details of its Internet First policy as it begins to nudge health and social care organisations away from the Health and Social Care Network (HSCN) and its predecessors to start running their services over the public internet, and is asking NHS bodies for feedback on its ideas.

The transition away from purpose-built networks within the NHS reflects wider government positioning around the use of the public internet – deemed “okay” by the Government Digital Service (GDS) back in 2017 – and supports its Cloud First strategy, which is itself currently undergoing a major shake-up.

Since his elevation to the post in 2018, health secretary Matt Hancock has been spearheading a digital agenda within the NHS, and in October 2018 he said that the health service’s use of online services, basic IT and clinical tools were far behind where they needed to be.

“We need to take a radical new approach to technology across the system and stop the narrative that it’s too difficult to do it right in health and social care,” he said at the time.

At the core of the Internet First policy are three main tenets set out by GDS: that new services should be made available on the internet; that they should be secured appropriately using best-available approaches; and that whenever services are being updated or changed, the relevant departments should seize the opportunity to move them onto the internet.

NHS Digital believes that making services available over the public internet will both support the growing need for health professionals to work flexibly and remotely, and reduce cost and complexity for organisations.

Ultimately, the transition to making services available over the public internet will see the flagship HSCN, which has been up and running since October 2017, phased out.

For now, however, HSCN – which was specifically designed to support the transition from private to public networking – will continue to provide ongoing access to systems and services not yet available over the internet and NHS Digital will continue to encourage health and care organisations to obtain internet connectivity as a HSCN service.

Eventually, though, health and social care organisations will need to have sufficiently scaled and functional internet connectivity to support their needs in consuming and providing relevant services; IT service providers will need to offer suitable secure user access and suitable secure application interfaces to external systems and services over the internet; and all digital services will need to be accessible over the internet at the earliest opportunity.

The exception to this will be any digital services due to be retired or replaced before March 2021, which fall out of the scope of the policy.

NHS Digital is now inviting health and social care organisations to have their say on its policy in a feedback-gathering exercise that will run until 14 June 2019.

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One of the critical skills shortages is of staff in GP practices who are competent to use the on-line services being rolled out. Whether that is because of lack of attention to the user interface or lack of training it has to be addressed.
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The NHS needs to have at least 2 networks. The first one has no public access at all so that it cannot be attacked. It operates for all hospital clinical/admin work and links to other hospitals for patient data sharing and G.Ps for referrals, results etc. A controlled portal allows messaging and data (authorised) to a public network where the public have read-only access.   
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