Transitioning from N3 to HSCN

By the end of the decade, the NHS’s N3 wide area network will have passed into IT history: as of 2017, the transition to the next generation Health and Social Care Network (HSCN) will begin.

According to NHS Digital, HSCN has been designed to “provide a reliable, efficient and flexible way for health and care organisations to access and exchange electronic information, while at the same time reducing costs and complexity, standardising networks, enabling service sharing, and extending the parameters of collaborative working.”

Implicit in that statement is acceptance that N3 is no longer fit for purpose and certainly not compatible with the vision and aspirations enshrined in the Five Year Forward View and National Information Board’s Personalised Health and Care 2020. With their clear commitment to patient-centric and integrated care, bringing health and social care organisations together for the first time, the talk has turned to enablement and innovation, agility and speed, engagement and dynamism, with technology as a key driver and facilitator.

“Better use of data and technology has the power to improve health, transforming the quality and reducing the cost of health and care services. It can give patients and citizens more control over their health and wellbeing, empower carers, reduce the administrative burden for care professionals, and support the development of new medicines and treatments.”

Technology as a driving force? Cue the spotlight being turned on BT’s10-year N3 contract ceasing as of 2017, and the consequent opportunity not to conceive ‘son of N3’ but to reimagine the whole network concept.

A quantum leap in health and social care

In their reimagining, NHS Digital has effectively gone in completely the opposite direction. N3 was designed more than 10 years ago, a single supplier network providing the NHS with access to a clutch of national applications, managed centrally on a long-term contract basis with BT. Its whole approach can best be described as monolithic, with a service seemingly predicated on ‘you’ll get what you’re given’ and obdurately non customer-centric. Over time, this lack of flexibility, coupled with growing technical stagnation and excessive costs, added up to N3’s death-knell. It also sounded the starting gun on delivering a replacement that is seen as fundamental to securing a quantum leap in health and social care provision, operational efficiency, clinical innovation and value for money across the sector.

So instead of a single supplier and a centrally managed network, HSCN is opening up a free market for accredited suppliers and building a ‘network of networks’, including, sensibly, the reuse of existing infrastructure where possible. What it creates is less a reshaped topology more a brand new national service concept. At a stroke, that achieves two key things: one, end users will now be able to take advantage of a wide range of products, services and contract terms that better align with their particular needs and objectives, choice pretty much denied them under N3. And two, free market economics come into play: more providers means more competition, which doesn't only help drive down costs but also encourages service-based relationships. More supportive, engaged working relationships can be instrumental in driving innovation and delivering quality outcomes. Plus, a vibrant market has an inevitable energy about it, which should percolate through to customers and stimulate an upshift in forward-looking projects.

The latter is vital because without that commitment – and the means to deliver – the vision will fail. HSCN is being created to support a world where anyone involved in the delivery of health and social care can access the records, information and services they need to do their job from any location at any time.

Take those in the community care area, for example. Currently clinicians working in the community can make notes while with patients, but in many cases they have to wait until they are able to access the network to upload data - often waiting until they are home or back in the office. This means vital patient care information updates can be delayed by 24 hours or more and are, as a result, unavailable from one service provider to another.

Green light for the game-changers

Therefore, that world will need to enable more mobile and remote working, more shared online system access, more regional collaboration, more ‘joined-up’ thinking and less ‘silo’ mentality. It will also need to be ready to cope with the increasingly complex applications that are set to be pivotal to transformational patient care. Look now and you’ll already find pockets of real technological sophistication, such as rapid radiology reporting services, with delivery in less than 20 minutes to hospitals and other healthcare departments. But game-changers like that need to be everywhere, or at least have the chance to be everywhere, the barriers to progress swept away.

Again in a departure from the restrictions of N3, NHS Digital is finalising a common set of connectivity, security and architectural standards; not only will this deliver the requisite degree of interoperability required, but it will also provide clarity and certainty on the supply side – and assurance on the client side – when designing new services and solutions going forward. It’s a green light for the game changers.

NHS Digital consulted extensively with service suppliers about HSCN. It’s abundantly clear that they listened as HSCN has far more of a private sector feel to it – choice, competition, client centricity, pragmatic contracting and commercials, continual improvement, these are all hallmarks of today’s relationship between enterprise and IT service provider. If you were being harsh, you could say that it is about time government ‘played catch-up’ in this respect, but to be fair, there isn’t another enterprise in the world that rivals the NHS and wider care estate for its complexities and sensitivities. That we are on the cusp of such a significant change is rather to be applauded.

Derisking transition to HSCN

The HSCN programme is totally impartial as to the procurement routes used for connectivity: the open market option is there to empower those who wish to manage their own network procurement arrangements, and they’ll be able to purchase HSCN certified connectivity services from numerous suppliers through almost any existing framework. For those who don't want to go it alone, there will be a centrally assisted procurement programme with simple mechanisms for the obtaining of a variety of communication services, including HSCN.

It would be natural, given the size, scale and scope of this change, for current N3 customers to have concerns about the required transition. But looked at dispassionately, each project is just moving from a legacy network to a new network; it's what network service providers, Recentric included, do every day: derisk and deliver. Network renewal is a regular feature of private sector IT, and these can be hugely challenging, complex, time-sensitive and always mission-critical. But they get done and done well, thanks to technical expertise, solid project management, open relationships, good communication, diligence, effort and will.

All of that capability, talent and resource is available to health and social care organisations too. And the advice is simple: engage with the market at the earliest opportunity. The aim of Redcentric is to make the N3-HSCN transition a no-cost change for our existing N3 customers, with absolutely minimal or zero impact on service. But that is incumbent upon customers sitting down with us in the very near term to map out what their HSCN future looks like. The medical world champions the positives of prompt review and diagnosis. We couldn't agree more.