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Digital Transformation in Health: The HSCN
By Francis Bell, Cloud Gateway
In a previous blog post we looked at the Government’s ‘Cloud First’ policy, and discussed some of the challenges faced by Public Sector entities attempting to migrate from the Public Services Network (PSN) to cloud. In this article, Cloud Gateway’s Francis Bell explores the impact of these strategies on the Health Sector, with a particular focus on the Health and Social Care Network (HSCN).
In November 2014, 18 months after ‘Cloud First’ policy was launched, the National Information Board published ‘Personalised Health & Care 2020’. This framework outlined the government’s intention to use technology and data to better coordinate the Health and Social Care sector, improving outcomes for patients and citizens. Of course, NHS Digital are playing a crucial role in implementing the broad range of projects covered by this framework.
One of the many portfolios of work that sits within this framework is ‘Paperless 2020’, an NHS strategy that focuses specifically on the use of technology and infrastructure to achieve these broader goals. Sitting within this strategy is the HSCN programme.
The Health and Social Care Network (HSCN)
Launched in April 2017, and the successor to the N3 Network, The HSCN is a data network for health and care organisations. The HSCN effectively creates a unified private network that health and social care providers and third parties can access, plus public connectivity to the internet. This means entities on the network are able to access and share information more reliably, flexibly and efficiently.
Previously, services on the central network were supplied by one provider, but HSCN is a standards based network, meaning organisations are able to obtain connectivity solutions from multiple service providers of all sizes, in a marketplace environment. This competitive marketplace encourages development of enhanced services, and perhaps most importantly, helps to drive down costs.
For all of these reasons, the HSCN is promoted by NHS Digital as an essential piece of infrastructure that supports the delivery of care, and in turn meets the objectives set by Paperless 2020 and Personalised Health & Care 2020.
By all accounts, the NHS appears to be successful in those aims. In a press release on 3rd July 2019, NHS Digital announced that the HSCN has resulted in savings of almost £50m per year. The teams responsible for implementing the HSCN recently won an Innovation award, plus have been shortlisted for a further Public Procurement award, announced in September.
However, migration is not yet complete, with many entities still connected to N3. The aim is that by 2020, all previous N3 connections will be provisioned through HSCN instead.
Internet First Policy
In March 2018, about a year after The HSCN was introduced, NHS Digital launched the Internet First Policy and Guidance. The objective of this policy is for all new digital services should be internet facing by default, and any existing services should be migrated as soon as possible.
The policy was introduced in response to the GDS ‘internet is OK’ statement in 2017, and is aligned to the wider ‘Cloud First’ policy that has been in place since 2013. It also complements the NHS Long Term Plan, and echoes the general industry consensus that the internet is set to become the backbone for much of our connectivity.
On the face of it, the launch of a new private network (HSCN), followed by an Internet First Policy is somewhat contradictory. However, Jill Sharples, Programme Head for Internet First, clarified that the two are intended to be complementary. In a Podcast with Innopsis linked here, Jill confirmed there is an expectation for elements of private networks to remain in operation for the foreseeable future. Getting systems and services internet-ready is going to be a long process, and until this transition is complete, both the HSCN and internet will have a place in the Health and Social Care infrastructure, and both need to work in harmony.
The challenge now for the Internet First programme is to explore solutions that can support the drive for services and systems to become internet-ready. There are a number of challenges that need to be considered, including:
- Security. Internet-facing services must meet the same (or better) security standards as private networks. Policy must be consistently applied during service migration from a legacy network to public internet.
- Reliability. The Internet First policy states “Organisations should ensure they have taken into consideration reliance on internet connectivity to access systems as part of their clinical risk assessments”. How can the risk of downtime or latency issues be mitigated for potentially life-critical services?
- Governance. The Internet First policy states “Organisations should govern their Internet First programmes of work through their usual governance processes.”. Some entities may need to operate hybrid infrastructures for long periods, or even indefinitely. How can the same governance be maintained when jurisdiction spreads across public and private ecosystems?
- Commonality across boundaries - Some local authorities provide services to Health and Public sectors. Services on different systems not only need to communicate with each other, but should also obey a common set of standards. GDS and NHS Digital are working with local authorities to establish a joint approach, but how will organisations abide by these rules when traffic starts to cross boundaries?
For Jill, the next steps are clear:
“It’s about working with those suppliers to say how do we deliver a secure scalable network provision that meets the future needs of transitioning over to the internet but at the same time supports our legacy systems.”
Jill Sharples - Programme Head Platform, Infrastructure and Live Services: Internet First Programme - NHS Digital. (Innopsis Podcast 24/06/19)
Over the coming months, I expect to see the nuts and bolts of the Internet First Policy explored in far more detail. NHS Digital have painted an image of the utopia for the Health and Social Care sector, but successful implementation can only happen through collaboration from organisations in the cloud and wider technology communities.
Cloud Gateway is an innovative UK-based startup founded in early 2017. It is a pioneer of Agile Networking and has developed an award-winning, NCSC compliant, hybrid cloud connectivity Platform-as-a-Service (PaaS) solution.
The platform encrypts network traffic, manages its movement through a central enforcement point, connecting businesses to any cloud service provider(s), including the HSCN, seamlessly and without disruption or impact to users. The focus is on facilitating a pace of change not previously afforded to organisations, particularly when faced with problematic legacy infrastructure.
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About the Author: Francis Bell is a Delivery Lead for Cloud Gateway. He is responsible for managing a seamless transition for new clients into live service, acting as a focal point for our Tech and Service teams. Francis recently joined the company having spent 8 years in the publishing industry. Since his arrival, Francis has quickly established himself as a valued member of the Senior Management Team, heading up a range of exciting Product Development and Partner Programme initiatives.