- Trust: Weston Area Health NHS Trust
The head of the NHSmail programme has said that he wants “most” NHS organisations to have migrated to NHSmail by the time its current contract expires in July 2013.
In a briefing to mark the first anniversary of the service’s move to the Microsoft Exchange 2007 platform, Will Moss told E-Health Insider that 200 organisations – ranging in size from foundation trusts to individual GP practices – were due to migrate before the end of the calendar year.
Moss said the programme was still hoping to move NHSmail onto the Microsoft Exchange 2010 platform this year and that it would deliver some new functionality, including ‘inbound’ SMS messaging.
But he said its main focus was now on migration, boosted by references in this year’s Operating Framework and Informatics Planning guidance that told trusts not to invest in their own email services unless they could produce a business case that would stack up against NHSmail.
“The priority has to be to move whole organisations so we can decommission existing services,” he said. “There are 565 top-level organisations in the NHS and 1,000 GP practices.
“By the end of the contract in July 2013, we need to have done most of those. Whether that will be front, middle or end-loaded I do not know. It will be driven by trust priorities.”
Cable & Wireless decided to move NHSmail off its Mirapoint platform in July 2008. The move to Exchange 2007 started in January 2009, and 350,167 live accounts were shifted over 12 weeks.
Sign-ups have since grown steadily. NHS Connecting for Health announced this month that NHSmail had reached the “major milestone” of 500,000 registered accounts.
Moss told EHI that half a billion emails and almost one and a half million SMS messages had been sent over the service since last April. “We will be doing a companion piece to outbound SMS, which is inbound SMS,” he added.
“We hope to provide inbound SMS this year.” This would allow patients to communicate with the health service, and, specifically, to respond to appointment reminders – which could help to cut ‘did not attend’ rates.
However, Moss emphasised that the NHSmail programme is focused on helping trusts to carry out migration projects. It has developed a tool to copy data from Exchange 2003 and Exchange 2007, and is working on a similar migration tools for other email platforms.
It has also produced a bulk registration tool to sign staff up for NHSmail accounts. CfH says the migration tool was proved in a pilot project at Weston Area Health NHS Trust, which migrated 1,800 staff from Exchange 2003 to NHSmail in November.
The next high-profile organisations slated to move include Sussex Health Informatics Service and the Royal Free Hampstead NHS Trust in London.
CfH has been running a campaign to persuade the chief executives, finance directors and medical directors of the 60 largest trusts in England to sign up for NHSmail.
It argues that trusts that need to provide 2,500 mailboxes could save £879,000 over five years by migrating, with most of the savings being made on servers and other equipment and the rest on maintenance and support.
Moss launched a vigorous defence of NHSmail as an enterprise class service, in response to comments on the EHI website claiming that large organisations could not use it as their sole email system.
“We have got 200 organisations in this calendar year to migrate to NHSmail. They are not doing it because it is a laugh or they have nothing better to do. They think it is fit for purpose and has benefits for them.”
He also rebutted comments claiming that NHSmail could not be used with other applications, such as SharePoint and Office Communications Server, although he acknowledged that it would not integrate with trust Active Directories.
“The AD question that should be asked is: would we look at federating local AD instances with a national instance and the answer is we would, but only if they had our level of security and they do not,” he said.
However, he argued that it should not be much effort to run NHSmail alongside other services that used Active Directory, and that any effort would be reduced once the service became CRS Smartcard compliant, which should happen “soon.”
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NHSmail: CfH respondsLyn from Digital Health 272 weeks ago
I asked NHS Connecting for Health if it would like to respond to the points made in the comments to this article.
In particular, I asked the agency to respond to the issue raised about the compatibility of NHSmail with the requirements set out in David Nicholson's letter, post the HMRC debacle.
In response, the agency has updated the NHSmail 'myth buster' section of its website, here: http://www.connectingforhealth.nhs.uk/systemsandservices/nhsmail/summyth
Lyn Whitfield, managing editor, E-Health Insider.
NHS Mail…the Publics perception of all this…?unknown 272 weeks ago
Time for some independent benchmarking? 2013 contract termination.unknown 273 weeks ago
The figures quoted by CfH are for a single Trust and come out at £70 per year per email account. Far higher than most Trusts pay, but let's put that to one side.
It would be interesting to see a benchmarking exercise between NHSmail and an email service hosted by a shared service - delivering economies of scale, whilst maintaining a local service desk. It would be also be useful to see a breakdown of the number of registered users of NHSmail and the number of individual people who have logged on in, say, the past month. Are accounts ever deleted after a period of inactivity, or are they left on the system to keep the stats up?
The call in the NHS OF/Informatics planning for a business case is easy to counter. The NHSmail contract ends in 2013 - so the costs of migrating from a local service to the National one, plus the cost of migrating onto "something else" needs to be taken into account and an estimate made of service charges beyond 2013*. Given our current costs are far less than the £70/user/year the business case for NOT migrating to NHSmail is very strong.
I'm not a lawyer but any contract of this magnitude would surely need to go back out to tender via OJEU? The chances of central funding being made available beyond 2013 is pretty remote in the current economic climate.
NHSmail was a bad idea back in 2003 when it was first mooted. It is better now than it was but putting lipstick on this particular pig doesn't make it any less of a pig. It is slow (restricted by N3 bandwidth rather than our local service which runs on a 1Gb backbone and 100Mbps switched LAN services between server and clients), not very user-friendly, unencrypted (unlike our local service), its SMTP domain addresses give no idea of who a person works for undermining corporate identity (I'm contracted to work for my Trust, not for "the NHS") and it only has three years left to run.
* this argument applies to all NPfIT contracts - the first big one to come up will be PACs - which should be fun!
are ALL clinicians and allied health professionals entitled?unknown 273 weeks ago
Given that a service as large as the NHS relies heavily on temprary, contract (inc Locum) staff, are ALL the individuals who are likely at any time to be handling patient identifiable information provided with an NHSmail account? The orevious poster suggests that there is a 'class' of NHS worker who isn't covered.
Much has been said in this thread about whether or not SSL (in transit) encryption ACTUALLY complies with the edicts from top NHS management after the publicity surrounding the child benefit fiasco a couple of years ago and there appears to be no confirmation forthcoming from senior NHS IT people to ratify this - is this something that EHI could take up?
The report into the Mid-Staffordshire case which highlighted that NHS management did not listen and then attend to genuine concerns raised appears to be the case here as well.
The Closed Shopunknown 273 weeks ago
As a contractor of 25+years of providing services to the NHS (both clinical and IT) - I am not 'entitled' to an NHSnet email address because "I don't work for a trust".
I rely on ms-outlook (as with rest of the world as an industry standard) when communicating with my NHS colleagues - NHSnet simply takes to much away to make it useful.
Disadvantages of NHS net email addressesunknown 273 weeks ago
1. Though NHSnet addresses are permanent so one should always be able to catch up with mobile individuals, at least with Trust email addresses one stands a chance of guessing where mail comes from (though many domains are somewhat cryptic), given that many folks' signatures are minimal or non-existent (though I admit that others are so expansive - many unfortunately as a result of imposed house 'style' and disclaimers - as to waste ink & paper if printed)
2. Unless things have moved on, NHSnet email requires one to remember 3 passwords which is why I no longer use it - it is essential to write them all down to be able reliably to enter the nth letter of each to get in, thereby defeating the objective of this extra 'security' . . .
Difficulties with NHS Mail as a corporate email systemcevers 273 weeks ago
No published service level agreement
No facility to restore mailboxes
No or limited compliance with many IG Toolkit measures
No flexibility on mailbox limits
No ability to archive without using an Outlook PC client
Main pointsunknown 273 weeks ago
First - The main reason large Trusts are not taking it up are valid ones of usability and integration
Second - Those Trusts provide mail systems that do the job for a fraction of what "they" think they do
Third - This is not some esoteric argument over who has the best encryption system. As someone pointed out PKI actually means that people who need to see things cannot.
NHS Mail has institutional endorsement but ambiguity still ragesunknown 273 weeks ago
The BMA - RCN and Chartered Society of Physiotherapy have all endorsed NHS Mail - see tinyurl.com/bmarcn
Is it possible that these organisations are not fully aware of the concerns raised in this thread?
Following the outcry over national data loss at the end of 2007 - the then interim DG of CfH - Matthew Swindells - wrote to all SHA CIOs with specific guidance re: personally identifiable information - the letter is here tinyurl.com/ylqcgx9
The first paragraph is crucial;
"I am writing, further to the recent letter from David Nicholson, to formally confirm that the movement of unencrypted person identifiable data held in electronic format should not be allowed in the NHS."
The letter shoudl be read in full for the full context however the statement is unambiguous.
Whilst SSL encrypts messages in transit - the data (mail messages which will have person identifiable content) is not encrypted and is retained in cleartext at either end as pointed out by the previous poster. Is the Jan 2008 statement from CfH therefore consistent with what is being requested by the same organisation in practice i.e.. a wholesale move across to NHSMail?
It is not an encrypted email systembriggella 273 weeks ago
It is a mailing system which has cleartext at both ends but uses an encrypted tunnel for email transport. That is not encrypted email. Encrypted email means that the mail is encrypted at one end such that even the sender cannot then open it, once locked, but only the recipient with their own key. Ie completely locked to the casual observer.
It might be fun to play with, but I wouldn't use it for sending patient data unless it were proper end to end encryption such as pgp/gpg. Of course if I send an email to Dr Haematologist with pgp, then Referral Management Centre wouldn't be able to read it and I guess that might be quite upsetting for them.