The NHS' transition to the new Health and Social Care Network (HSCN) is underway and services are expected to fully commence in October.
The new NHS data network provides the infrastructure to connect health and social care organisations across the country and allows to them access and exchange electronic information.
The disaggregated supplier model will replace the N3 network, which had been delivered and managed exclusively by BT for almost 15 years.
N3 was designed to bundle numerous services together, but critics say the single-supplier model lacked the competition necessary to drive down costs and encourage innovation.
It was also viewed as being too inflexible to support the kind of collaboration and information sharing required by the government's decision to integrate health and social care services.
The expiration of the N3 contract in March 2017 provided an opportunity to establish an improved service with a large base of suppliers.
"The way to get true competition is to ensure that you achieve full disaggregation," says Michael Bowyer, the industry lead for the creation of the HSCN Obligations Framework and the director of public services trade body Innopsis.
"The beauty about this particular model is that it actually doesn't prescribe the solution that the suppliers must set up.
"It sets out the service availability and technical obligations that a supplier must meet at a minimum to supply compliant HSCN service, but the suppliers themselves are then free to be innovative about what type of connectivity to supply to meet the customer demand."
Providers gain accreditation to supply HSCN services after completing a three stage compliance process. Stage one compliance is granted after the company shows it can deliver the relevant services securely and satisfy a set of information assurance businesses continuity management requirements.
The next stage is completed when they connect their infrastructure to the peering exchanges and prove functionality, and the third and final stage once they are fully operating a range of HSCN customers.
The idea behind HSCN is that it will improve access to treatment information to anyone delivering health or social care services. It will also offer suppliers with the opportunity to provide services in specific regions where they have expertise and capabilities.
Remote areas of the country have their own GP practices, dental practices and hospitals, but the connectivity options available to them have traditionally been restricted.
HSCN lets the customer specify the service they want, and as the connectivity is not prescribed by HSCN, suppliers can take their own approach to how they provide it.
"The headline is better, faster, cheaper," says Darren Turner, managing director of Carelink, the longest serving managed services provider for NHS networks, and a recent addition to the growing list of suppliers with stage one compliance.
"Everybody is going to get more bandwidth now, so just in terms of that service capability that's going to be better," he says. "Everything's going to be faster and be able to move around quicker, and that's a factor of that multi-supplier landscape."
HSCN also supports the NHS Digital strategy to migrate all of its data and applications securely onto the cloud by allowing suppliers to provide the connectivity to access any cloud services that the customer requires.
"We can provide a whole range of cloud and application solutions to them from our portfolio of products, almost providing a one-stop shop for them to meet all of their infrastructure and network service requirements," says Turner.
Preparation for HSCN
Concerns were raised last year that both the NHS and the network were unprepared for the migration.
Broadband services provider Updata, a subsidiary of controversial outsourcing and services company Capita, published a whitepaper in September warning that many NHS organisations were unclear about the implications.
To address this, N3 was moved to a transition network on 1 April 2017, which Bowyer describes as a "painless exercise".
This arrangement will operate for three years while users migrate from the legacy network onto HSCN, which is expected to result in savings to the procuring authorities of 35-40 percent.
Bowyer is confident that the extensive planning behind the transition programme will ensure that all users have migrated to HSCN by the target date of August 2020.
A necessary move?
Turner says the static, monopolistic model of N3 made it "a fortress that became a prison".
The analogy suggests that security may have been sacrificed for the freedom of multiple providers.
Bowyer argues the risk has in fact reduced, and that the requirements for information assurance have changed dramatically since the launch of N3 applications.
The network now needs to connect not only internal NHS systems but also the councils providing social care and the commercial suppliers that deliver services into the NHS, such as chemists.
In theory, these organisations could cut the high operating costs of legacy systems and extend those savings to the customers who buy their products, such as medication in the high street stores.
"You have to create a network that would allow anybody that's delivering a healthcare or a social care service to be able to connect to this network, but it doesn’t mean that we've created a network where it's a hackers delight. Far from it," says Bowyer.
"What we have created is a set of robust security challenges. I'm certainly not going to claim it's a totally secure network, that would be misleading. But it is a robust, secure solution in terms of good industry practice."
He adds that many of the risks have been mitigated by the obligations on organisations to deliver the services.
"The beauty about HSCN is that if the supplier is deemed to be not performing well after all the processes that have actually taken place, actually replacing that supplier is a relatively easy thing to do - because of the disaggregation model - by the authorities," he says.
"I would say that the model is actually a damn side more robust than a single supplier."