Interview: Dermot Ryan and Patrick Clark of NHS Digital explain the priorities for encouraging take-up of the new Health and Social Care Network
NHS Digital plans to “turn the tap on slowly” in bringing organisations onto the Health and Social Care Network (HSCN). The first phase will be focused on migrating the NHS bodies on the legacy N3 network; then will come the effort to attract social care and other new users.
A conversation with programme director Dermot Ryan and head of migration Patrick Clark makes clear they have no intention of trying to hurry organisations into connecting, but believe that over the next year a strong momentum will develop.
“We’ll be in the early adopter phase to the end of the calendar year and have about 100 organisations we want to come on in that period,” Ryan (pictured) says. “We will taper up as we go and ensure everything is working right.
“We’ll look to limit numbers this year, and next year move into full roll out, but even within that will ramp up from modest levels in January to peak rate in late summer. We don’t want to take undue risks.”
The HSCN is ready to come onstream as a more extensive replacement for the NHS N3 broadband network. It has been developed to bring social care onboard as part of the broader campaign to join up with its services with healthcare.
NHS Digital, which is managing the network, passed a crucial point in its delivery in the spring with the installation of its peering exchange – a switch for all the customer network service providers – and has 12 suppliers compliant to provide connectivity services with 10 more going through the process.
It is now working on plans for the first round of connections with an early focus on organisations with N3 contracts due to expire. These are going to need a network to connect to national and regional applications and to share information.
“We don’t need to say too much to them, just that the need for continuity means they should get on to HSCN,” Clark says. “But we are making clear there are a number of benefits in the new arrangements.”
They see early movement among regional groups running aggregated procurements for the services, the strongest being in Yorkshire and Humberside – which has accounted for about 12% of the N3 estate – and in London.
Clark says there have been a few collaborative procurements in which organisations have self-organised to deliver a regional network, and aggregated procurements run by HNS Digital on behalf of healthcare organisations to deliver a similar outcome.
Social care outlook
Both men are sanguine about bringing in social services in the early days, but make clear this is a crucial element of the long term outlook.
“The fact we’ve called in the Health and Social Care Network makes clear we expect social care organisations to be able to adopt it to communicate with NHS partners,” Clark says.
“Some of those NHS organisations have reached out to social care partners regardless of what we do in the centre. They recognise they have to provide joined up services and have policy drivers like STPs (sustainability and transformation partnerships).”
Ryan adds: “We’ve been working closely with the Local Government Association to act as a proxy on behalf of social care, to try to ensure any group procurement exercises we are doing could pick up social care.
“The organisations are being encouraged to think about whether it is right for them. We are seeing that some, with a bit of prompting, are joining the fold.”
But they say that social care providers will have plenty of time to join the network, and will not have to be part of any aggregated procurement. They can buy connectivity services at any time from any of the compliant suppliers and this will give them access to the HSCN.
“Some might have contracts with three or four years to run, but it might be with an HSCN compliant supplier which gives them opportunities to use it,” Clark says.
They also emphasise that the network is not only open to local authorities, but other care providers such as care homes, and organisations such as the emergency services that need to share relevant information.
“The only barrier to entry is to have a legitimate need to connect to the network to get access to the resources that are on it,” Ryan says. “If you’re involved in care provision and have a legitimate need it should be easy to demonstrate it.”
It relates to what could be one of the big prizes on offer – the development of integrated care records for the NHS and social services. Clark says that HSCN provides the underlying infrastructure to make the systems more attainable, especially as it is based on standards in which interoperability is a big factor – along with network management and security.
This provides plenty of scope for organisations to work with compliant suppliers in developing integrated records, and they can develop their own information governance requirements, making them proportionate to the nature of the data and who has access.
“We don’t want the network to get in the way of those data owners’ decisions on how best to do it,” he says. “It’s not necessarily going to happen from day one, but the opportunity to take that approach is there.”
Clark points to other benefits from the network: “At the top is that it will be much more cost-effective. We expect price points to be lower than under N3, and it’s there in the ability to collaborate with other NHS and social care organisations in the provision of the network.
“There is more scope for aggregated buying and collaboration, and a lot of it is about getting the shared infrastructure in place for all sorts of digitally enabled services, and to ease their ability to share information reliably and efficiently.”
It can also provide scope for organisations to access applications hosted nationally, regionally or locally – going down the chain to clinical commissioning groups and GP practices – and can support the effort to establish STPS for the closer working of health and social care.
Efforts to implement the latter have stuttered, but Clark says that while there might be issues around organisations and information governance in joining up the two sides, the interoperability in HSCN can provide the “network perspective” to meet the needs of both sides.
The other major benefit is in security, with two significant elements of the HSCN due to go into operation next month under NHS Digital’s Security Operations Centre. The Networks Analytics Service will monitor activity and identify any anomalous behaviour, while the Advanced Network Monitoring function will watch in- and outbound internet traffic and filter out any malicious content
“It looks at aggregate traffic around the network and is able to spot patterns in sending and receiving data,” Ryan says. “It might point to cyber activity and provides us with eyes and ears on the network to intervene early in the event of a cyber attack.”
They also say the connection demands for public sector organisations are not at all onerous.
“It’s just confirming they are doing things they should be doing anyway,” Clark says. “And providing key contacts in the organisation to us so we can communicate with them on any issues.
“It’s more about having a register of people on the network than demanding they show us a lot of information governance arrangements in place. We’re not going to be auditing that in any heavy handed way.”
It is very early days for the HSCN. The fact it is replacing N3 will probably ensure its widespread use within the NHS over the next couple of years; but the big test of its success will be whether it is also picked up widely by the social care sector and provides the basis for the integration that both sides desire.
It has been an aspiration for a long time, and proved painfully slow in becoming a reality. While NHS Digital may be careful not to rush the social care providers, the dialogue with them will be crucial.