Message Exchange for Social Care and Health

Message Exchange for Social Care and Health (MESH) is a secure messaging service used by health and care organisations to exchange data and documents.

You can use MESH to:

• send files between organisations securely
• exchange structured messages between systems
• transfer large datasets
• deliver information to the right recipient using predefined message routes

MESH works like a secure digital post service. Organisations send messages to a MESH mailbox, and recipients collect them from their own mailbox.

Depending on your needs, you can:

• integrate directly using the MESH API
• automate file transfers using MESH Client
• send and receive messages manually using MESH UI

MESH is used across health and care to support direct care, national data collections and operational data exchange. Based on the access method you choose, files of up to 50GB can be transferred securely between organisations.

Choose the option that best matches your task.

Integrate an application with MESH

Use the MESH API to send and receive messages directly from your application.

Best for: suppliers, developers and teams building system-to-system integrations.

Go to: MESH API documentation

Exchange files automatically

Use MESH Client to automate file transfers between organisations without building a full API integration.

Best for: organisations transferring files between systems using a managed client.

Go to: MESH Client guidance

Send files manually

Use MESH UI to send and receive files through a web application.

Best for: low-volume or ad hoc message transfers where automation is not required.

Go to: MESH UI guidance and account requests

Get started with MESH

Find out how to apply for a mailbox, access the service and complete onboarding.

Best for: organisations and teams that are new to MESH.

Go to: Getting started with MESH

Manage workflows and mailboxes

Learn about workflow IDs, mailbox configuration, endpoint lookup and message routing.

Best for: teams implementing, configuring or extending existing MESH integrations.

Go to: Workflow IDs and mailbox guidance

Get support

Find troubleshooting guidance, service contacts and support routes for onboarding, testing and live service issues.

Best for: anyone experiencing problems with MESH.

Go to: Support and troubleshooting

API

Use the MESH API to integrate MESH directly into your software.

Suitable for:

• suppliers
• developers
• organisations building system-to-system integrations

Benefits:

• direct integration
• automation
• large file transfers

Get started: MESH API documentation.

Client

Use MESH Client to automate file transfers without building a full API integration.

Suitable for:

• organisations exchanging files between systems
• teams with server infrastructure available

Benefits:

• automated transfers
• simpler implementation than a custom integration
• large file transfers

Get started: MESH Client guidance.

UI

Use MESH UI to send and receive files through a web browser.

Suitable for:

• low-volume file transfers
• ad hoc messaging
• users who do not need automation

Benefits:

• no software installation
• manual upload and download
• suitable for smaller transfers

Get started: MESH UI guidance and account requests.

MESH enables health and care organisations to send and receive messages securely.

It supports:

• organisations exchanging data between systems
• organisations transferring files manually
• national and local health and care services

MESH is used across the UK and is also available for some international use cases.

MESH provides the ability to share data directly with other organisations and we recommend its use in this context.

You can use MESH to send messages of any type, for many reasons.

Support for direct care

• send and receive vaccination data to NHS and supplier systems
• send machine readable pathology reports securely and reliably to GP Systems
• receive reliable data that ensure patients record are updated correctly

Large data transfers

• send datasets to NHS England
• receive a list of NHS numbers from the national data opt-out programme

For a full list of nationally-defined messages, visit our API catalogue, filtered to show MESH integrations.

MESH enables senders and recipients to exchange messages securely and reliably. 

1. Sender uploads a message to MESH via their outbox.
2. The MESH service holds the message until the recipient is able to retrieve it.
3. The recipient retrieves the message and acknowledges the successful download of it. We recommend polling to retrieve every five minutes.
4. Sender is able to track the delivery status of sent messages.
5. A non-delivery report will be sent to the sender if the recipient doesn't retrieve the message within 5 days.

The service also provides message routing controls and directory services. Messages can be given a Workflow ID, which helps recipients understand the type of message they are receiving. For more information, visit MESH: Workflow Groups and Workflow IDs.

MESH supports 2 delivery-routing configurations - carbon copy (CC) and redirect.

These configurations allow messages to be duplicated or re-routed based on predefined criteria. They are applied automatically by the service when a message meets the configured conditions.

Overview of CC and redirect

CC creates an additional copy of a message and delivers it to another mailbox. The copied message will produce a new message with a different MESH message ID. The original recipient still receives the message.

Redirect replaces the original recipient with a different mailbox. The original recipient does not receive the message.

Both CC and redirect are applied during message delivery. They are configured by the MESH service team.

Difference between duplication (CC) and redirection

CC delivers to the original recipient and to one or more additional recipients.

Redirect delivers only to the replacement recipient. The original recipient does not receive the message.

Examples

CC example (copy for an authorised partner system) - a GP practice receives discharge summaries on a workflow ID. A CC rule on the practice mailbox copies each message to an authorised partner mailbox so both receive the same content automatically.

Redirect example (temporary division) - during a migration, a redirect rule routes results for a workflow to a new mailbox. When the migration completes, the rule is removed.

Configuration

CC and redirect are defined using configuration entries managed by the MESH service team. End users and senders cannot set rules themselves.

CC configuration requirements

The required field is:

• cc_to_mailbox_id (target mailbox)

Plus at least one of:

• cc_if_sender
• cc_if_recipient
• workflow_id

Redirect configuration requirements

Required fields are:

• redirect_to_mailbox_id (replacing mailbox)
• redirect_if_recipient (original intended recipient)

Configuration notes

A GP practice may receive multiple workflow IDs. Where needed, create separate CC rules per workflow.

Some workflows are restricted (such as GP Connect/GP Federation, certain PDS demographic data). These may require programme approval and/or conformance. CC cannot be enabled for restricted workflows unless the receiving organisation has the appropriate approval.

Behaviour

Automatic application:

• when a CC or redirect rule is active and a message matches the configured criteria, MESH applies the rule automatically. Senders are not notified that the CC or redirect has occurred

CC behaviour:

• a carbon copy creates a second copy and delivers it to the specified target mailbox. The original recipient will still receive the message. If more than one CC rule matches, each CC target will receive a copy

Redirect behaviour:

• a redirect only delivers to the mailbox specified in the redirect link. The original recipient will not receive the message

Rule precedence and fallback

Precedence: redirect takes precedence over CC. If a message matches both a redirect and a CC rule, redirect is applied and the CC does not generate an additional copy.

Fallback: if a redirect is later removed while related CC rules remain active, deliveries will fall back to CC behaviour. Requestors should declare any existing CC rules when asking for redirect to avoid unintended outcomes.

This service has been live since 2015. It is an evolution of an earlier service called Data Transfer Service (DTS). In terms of usage:

• there are over 400 different message types in use per month
• there are around 22,000 active mailboxes in a given month
• it handles around 30 to 60 million messages per month

It is a platinum service, meaning it is available and supported 24 hours a day, 365 days a year.

Before choosing an access route, make sure you:

• have a valid business use case for using MESH
• know whether you need API, Client or UI access
• understand any onboarding requirements for the service you are connecting to
• know which workflow IDs and recipient mailboxes you need to use

Before you apply

The information you need and the onboarding process will depend on how you plan to use MESH:

Important

If MESH is being used as part of another service, such as GP Connect, you may need to complete onboarding for that service as well as MESH onboarding. Your onboarding requirements will depend on the service you are connecting to. 

Need help getting started?

If you're not sure:

• which access route to choose
• whether you need a mailbox
• whether a workflow is already available
• who owns onboarding for your use case

contact the MESH team before starting your application.

You can access MESH in a number of ways. All options are free to use, but you need to show you have a valid use case to use MESH.

You can also use a combination of these options, which you’ll need to set up each one separately.

MESH is available over the internet and over the Health and Social Care Network (HSCN).

Onboarding time: minimum 1 month

You'll need:

• a valid use case
• system integration capability
• completion of MESH onboarding requirements

Onboarding time: typically 1 to 3 weeks

You'll need:

• system administrator access
• a server environment
• mailbox setup

Onboarding time: typically 2 to 3 weeks

You'll need:

• Care Identity Service authentication
• a MESH UI account

The timings already exist on the page, but they are currently embedded within longer paragraphs.

MESH guidance hub

View our selection of MESH and MOLES technical documentation. These guides will help you install and use your MESH client, manage your advanced settings and identify recipient mailboxes using the endpoint lookup service.