NHSmail is more than just an email service. The system manages the identities of all users within the Microsoft Active Directory in the NHS and allows local administrators to manage accounts within the NHSmail portal.

Typically, NHS organisations will manage local identities within their own Active Directory and use the NHS Electronic Staff Record for workforce management, including the on-boarding and off-boarding of employees.

This may all sound straightforward and a bit technical, but the reality is that all of this has put significant burden on back offices across the NHS. Local organisations have had to manually manage employees that join, move or leave their roles within NHSmail, as well as their local active directories and Electronic Staff Record.

With more than 13,000 health and care organisations in England and Scotland using NHSmail and 64,000 movements of user accounts every month, the burden is real and the security implications relating to identity are acute. But that also means the opportunity for improvement is significant.

We are delivering three important improvements to workflows and to integration with local processes.

1.    A new Joiners, Movers, Leavers (JML) product integrates the Electronic Staff Record, NHSmail, and local directory services. It automates the movement of user accounts between NHSmail organisations, the synchronisation of attributes and the commissioning and de-commissioning of local identities in the active directories.  When fully implemented, this process is expected to save around 40,000 hours a year, leading to millions of pounds worth of efficiency savings.

2.    A password synchronisation micro-service allows users to synchronise their password from the NHS Directory to their local active directory services and vice versa. This will also improve user experiences by delivering a same sign-on experience regardless of whether they authenticate for services against the NHS Directory or local Active Directory services. It will also improve cyber security by reducing the number of passwords users need to manage, reducing the temptation to store them in an insecure way – such as post-its with user-names and passwords written on them and stuck to desktop or laptop monitors.

3.    Behavioural and transactional analysis will allow us to identify patterns in user behaviour and associated digital transactions to help pinpoint anomalous events. For example, if a user attempts to authenticate a service from an unusual location or an odd time or date the service can block authorisation in case the account has been compromised.

These new services build on a series of improvements to the NHSmail platform over the past year, including:

These enhancements are complemented by continued filtering and monitoring of spam and malicious activity at the NHSmail gateway. On average, we stop about 500 million malicious events every three months.

There is still a lot more we can do to improve user experience and data security on the NHS’s communications systems. As part of our work to support the NHS Cyber Programme and deliver NHSX’s Tech Vision and Long-Term Plan, we will continue to work to improve cyber preparedness and capability while relieving pressure on local teams.