The idea: health and care providers should now be able to obtain network connectivity from multiple suppliers in a competitive market place, and in collaboration with other health and social care organisations, replacing the single-supplier N3, which had been designed as a way for NHS providers to access national applications.
As with all things NHS and digital, moving off N3 onto HSCN is a big job - NHS Digital itself doesn’t expect N3 to be fully turned off until March next year. And again, as with all things NHS and digital… by the end, N3 had started to look pretty tired.
One Trust that has seized the chance of ditching it is University Hospitals Plymouth NHS Trust (UHPNT), which says it had started to feel the thing was well out of date - and given its current bandwidth was failing to meet the organisation’s needs and that N3 network was fully saturated nearly all the time, you can see why.
Plymouth was thus one of the first healthcare organisations to join HSCN, so we asked them what the results were. The headline version? They seem pretty keen:
We've got 10 times more bandwidth available to us and at 20% lower cost than what we were paying with the older N3 connection. From our perspective, that's already a win-win.
Thus the organisation’s Head of IT infrastructure and support services Rob Harder, who walked us through his team’s journey from N3 to HSCN by starting with giving us a sense of the scale of the initial challenge. Just on its own, University Hospitals Plymouth NHS Trust is the largest hospital in the South West peninsula, providing the region with comprehensive secondary and tertiary healthcare services.
Beyond its provision of secondary services to some 450,000 people from Plymouth and the surrounding area, it’s also a major trauma centre and provides tertiary and specialist services to a population of over 2m people. Its staff rely on the network to access patient records and information, as well as clinical applications that run over the network, so it really needs to have fully resilient connectivity to make sure its clinicians are informed and well-equipped to treat patients in potentially life-threatening situations. Harder says:
Going from N3 was a welcome change really; we’d been suffering from limited bandwidth. We've got a large, acute hospital providing many services locally and regionally but we were only able to have a 100 Megabyte connection with N3 - we couldn't get anything bigger than that, because of the constraints of the contract with the N3 service provider. So we've been struggling with that amount of bandwidth for a number of years. When the announcement was made that N3 was to be replaced by HSCN, we welcomed it with open arms, to be honest.
But another factor was the need to co-ordinate the move with affiliated NHS partners in the region, he says: no less than nine bodies needed to come together to make the transition work, including his organisation but also North Devon NHS Trust, Devon Partnership NHS Trust, NEW Devon Clinical Commissioning Group (CCG) and hospices from Plymouth, Torbay, Barnstable and Exeter, which came together under the umbrella term of ‘the Devon Collaborative’.
There is also the fact that a new relationship would be needed on the sell-side, too:
We are moving away from N3 being provided by a single provider and supplier to something being provided by multiple suppliers, so it was a challenge for those suppliers to become accredited to provide HSCN services From an end-user perspective and as an NHS Trust, our requirement was just to go through a procurement exercise to select the supplier that we felt would provide us with the sort of best wrapper of services around that accredited and structured HSCN provision.
Once the preparation had been made, UHPNT and its partners went to market, with a desired solution needing to offer Fibre-to-the-Premise (FTTP) connectivity to future-proof reliance on the cloud and to ensure some long-term elbow room.
‘HSCN is a true enabler of NHS digital transformation’
Eight suppliers bid, says Harder, with the eventual winner, MLL Telecom, partly pipping the post due to its ability to deliver the most cost-effective service and the quality of its proposed solution, he states. The full cutover to HSCN was completed in May this year with his new partner, and took six weeks - as short a timeframe as was reasonable to get the job done while also avoiding network downtime, Harder says:
Since that date, we've had a 10-fold increase in bandwidth and a lot of the issues that we have been experiencing and suffering from over the last three to five years, as we've outgrown the available bandwidth on N3 - all of those problems, like our patient administration system and our radiology information system not being as available as we’d like, those problems have completely gone away.
That means that our clinicians can now access those applications, without contention of bandwidth getting in the way and either making it slow or almost impossible for them to access those information systems. That's been a really big thumbs up for us.
It's also set us in a place where, looking forward, we can start to look very seriously at moving more services into the cloud and hybrid cloud through that additional bandwidth we have available through HSCN. It also start to enable us to communicate and collaborate with our sister organisations around the NHS - locally, regionally and even nationally, more effectively, because we've got that greater bandwidth available.
Examples of same include using video conferencing services for multi-disciplinary team meetings to discuss patient care associated with the specialist services that we provide out of Plymouth Hospitals. And as UHPNT is a regional trauma centre and cancer specialist Trust, that means conversations can take place to help patients over video conferencing with specialists and referring clinicians at various hospitals in the region, without the need to travel. Harder adds:
Now we have connectivity fixed, our IT team is much better placed helping the organisation with digital transformation - looking at things like digital care record solutions that we can deliver to help transform and improve services for our patients, more than just managing traditional infrastructure.
Summing up, for Harder - and perhaps many other NHS IT leaders - the conclusion is:
N3 turned out, unfortunately, to be quite restrictive - but HSCN is a true enabler of NHS digital transformation.