There are a number of key findings from NHS Digital’s engagement activities to date which can be categorised under the following four themes:
In principle consumers and suppliers of digital services recognise and support the Government and Secretary of State for Health’s vision to move to Internet First.
Many organisations have built their digital services and architecture on the provision of a centrally provided national private network and will have to initiate a significant change programme to move away from this reliance.
A significant proportion of legacy systems were not designed to operate outside the boundary of the national private network, N3/Health and Social Care Network (HSCN) or secured to be accessible over the internet and any ‘rush’ to make this happen adds risk and costs.
A number of organisations are planning to move to cloud services but see this as a five year plus plan.
Information is needed on the health and social care’s strategic direction for Internet Protocol (IP) Addressing, in order to deal with the issue that the availability of IPv4 address will be exhausted in the next few years.
The wider health and social care sector have a dependency on the NHS Digital roadmap in order to remove their reliance on the centrally managed private network.
Concerns were raised on the local capability to define, negotiate and manage contract terms. A central body (NHS Digital presently) is able to utilise economies of scale to leverage control over suppliers to ensure best value, financially, contractually and for quality of service.
Concerns were raised around the capability to rearchitect products that had accumulated significant technical debt and knowledge of how systems operate has been lost over time.
There is a general misconception that private networks, are secure and some applications were developed on the basis that the risk of attack on the private network did not exist.
Organisations also raised concerns that under Agenda for Change pay restrictions they are unable to resource locally at the higher level of subject matter expertise. Leaving a reliance on central bodies for access to this expertise, for example security/cyber.
There was a lack of awareness on the full service offering of HSCN and the knowledge that it had been designed to support transition to Internet First providing both private and bidirectional public connectivity.
Further advice and support on how to implement the Internet First policy is required for the less digitally mature organisations.
Additional costs will be incurred to update digital services and infrastructure. This will be exacerbated if carried outside of planned ‘technology’ re-fresh points.
Replicating the oversight and support provided by the central body (NHS Digital) at a local level will increase the overall cost to the health and social care sector as well as at a local level (removing the economy of scale).