NHS needs broadband

The future of NHS IT and the development of Broadband Britain are inextricably linked.

The health service needs increased bandwidth to cope with medical advances, and the UK needs NHS and public sector contracts to convince broadband service providers to invest in infrastructure.

A national high-speed network connecting hospitals, health trusts and GPs may be a perfect example of the approach.

A high-speed health service network would mean better care for more of the people more of the time, but only if government plans for bringing broadband to rural areas can be made to work.

The existing narrowband NHSnet is used for email and simple applications such as test results and patient referrals. But advances in clinical software will make broadband a necessity in the next two or three years.

A government-led project is developing a single electronic patient record (EPR) instantly accessible anywhere in the UK.

Hospitals and GPs are trialling a variety of clinical messaging systems for transferring laboratory test results, and scans and X-rays for diagnostic imaging.

And software is being developed to transfer prescriptions from GPs to pharmacies.

The combined effect will be better information to support doctors, and thus better patient care. For example, doctors would be able to send high-quality electronic images, such as neuroscans, to a specialist.

Of these developments, only diagnostic imaging actually requires broadband.

But the existing network wouldn't cope when the new technologies achieve widespread use, says NHS Information Authority (NHSIA) head of access to information Carrie Armitage.

'What is needed is a network that can support all these things being done everywhere,' she said.

Existing hospital connections are between 512 Kbps and 1Mbps, and doctors' surgeries nearly all use dial-up modems. But to make the most of what is coming, everyone will need at least 2Mbps, says Armitage.

The contracts for NHSnet, held by BT and Cable & Wireless, expire in 2004, and discussions about the new requirements are already underway.

Health service representatives are in preliminary talks with telcos about the future of NHSnet, with the official purchasing procedure due to start in the autumn. Under European law large public sector contracts have to be publicly advertised in the Official Journal of the European Community.

A broadband NHSnet is an ambitious plan. It would be the UK public sector's first truly broadband national network. But it will have to overcome the problem of availability.

'One of the things that will be difficult will be getting the telcos to deliver equality of access, because outside the metropolitan areas coverage is patchy,' said Armitage.

'There will be areas of the country where access will be easy and there will be good competition from telcos, and we will be able to get good prices. But there will be other areas where it will be very difficult - and these are the areas that need it the most.'

This is the problem facing public sector, private sector and individual consumers. Telecoms suppliers say it is uneconomical to provide connectivity in rural areas because there are not enough end users to cover the costs. The government's plan is to use the combined weight of public sector demand as an incentive for commercial telcos to invest in rural areas.

The NHSIA is on the study group looking into the logistics of aggregating government requirements. The group, run by government purchasing arm the Office of Government Commerce, is due to report at the end of this month.

If it works, aggregated demand could offer enormous benefits.

'I can't say categorically hand on heart that I can see the way forward for UK broadband - it's incredibly ambitious - but I do think there is value in exploring how we can work in partnership,' said Armitage.

'The answer is not just round the corner, but there is a huge amount of benefit for health integrating with other parts of public sector at both the national and community level.

'We want a networked NHS, rather than an NHS network - health is not just the NHS but also social services and even education so it makes sense not to have an exclusive health network.'

Bandwidth is the health sector's most crucial issue.

'The priority is to look at ways to increase bandwidth,' said Armitage.'It's the only way we can support the NHS plan.'