Getting NHS buy-in for PSN is a headache, says experts

NHS buy-in to the PSN is being stymied by fixed ideas around patient data security, central funding of the N3 network and a distributed governance structure

NHS buy-in to the Public Sector Network (PSN) in the UK is being stymied by fixed ideas around patient data security, central funding of the N3 network and a distributed governance structure, according to several key players within the PSN who were speaking at a roundtable this morning.

The PSN is a collaborative network that ultimately aims to see all local services within a fixed geographical region provided over the same data infrastructure.

The PSN has been mandated at a central level by government CIO Joe Harley, and is being pushed at a local level by local authority body Socitm, among others.

Many local authorities have already established PSN services, including Kent, Staffordshire and Essex.

However, all attendees at today's roundtable agreed that getting the NHS involved in discussions around the PSN is a headache.

Jon Browne, technical lead at Yorkshire and Humberside PSN Project, explained that the problem limited the potential cost savings achievable and that NHS involvement would give them far more clout.

"As a county council we currently bid for approximately £12m in services whenever a contract is up; however, with buy-in from the health trusts we would be submitting bids for approximately £18m. We would benefit from bigger economies of scale if they were on board."

Jason Peach, head of professional services at infrastructure support services firm Networks First, explained that one potential hurdle for suppliers and councils looking to get the NHS on board is that the NHS is driven by ethical considerations around handling patient medical records.

Brown agreed: "They don't tend to see patient records as citizen records, and so are frankly unwilling to merge services."

The Kent Public Sector Network serves every public service except health - including district authorities, county council, education establishments (colleges and schools) fire and rescue and the police service. And it has done this by aggregating the services onto the UK's education and research network, Janet, which provides two 10Gb pipes to the area.

Jeff Wallbank, partnership development manager for the Kent PSN, said he had been trying to engage with the health community around shared services for 25 years.

Getting NHS buy-in for PSN is a headache, says experts

NHS buy-in to the PSN is being stymied by fixed ideas around patient data security, central funding of the N3 network and a distributed governance structure

He explained that the council would have considered aggregating services via the NPfIT's N3 network - this is a network that delivers patient services - but the Information Governance Statement of Compliance (IG Soc), the process by which organisations enter into an agreement with NHS Connecting for Health for access, did not allow this aggregation.

"You say you've got IG Soc, can we aggregate it? And Connecting for Health says, 'No you can't'. This is a stumbling block that needs to be unpicked," he said.

Another problem with the N3 network, which was considered one of the successes of the widely derided NPfIT, is that access to it is partly funded via central government through the Community of Interest geographical networks (widely called COINS), meaning access to the network is actually around half the price it would be if it were not funded.

It is difficult for local suppliers to match the price offered here, and so there is no motivation for health trusts to leave it, again preventing aggregation of networks.

Another issue is that the N3 is hailed as one of the few successes of the NPfIT, meaning there is an emotional attachment to it, according to Peach.

Similarly, organisational change within the NHS has perhaps created a barrier to uptake, according to Wallbank: "The PCTs are about to undergo a reorganisation, and so are perhaps unwilling to commit to services when they won't be in the same position within 12 or 18 months."

The situation is very different in Scotland and Wales because of a more collaborative governance structure.

The Welsh Broadband Assembly took the funding centrally, compared with funding in England, which was distributed to local authorities, and established the Public Sector Broadband Aggregation (PSBA) network. This connects the police, schools and colleges, health service, councils and others.

"This service sees Wales aggregating services the way it should be done," said Vic Baldorino, executive director of public sector networks supplier Updata.

In Scotland, the situation is again easier to manage - a centralised e-care programme means that health services share networks with the council.

And the fact that Derek Feeley, CEO of the NHS in Scotland, was recently reappointed as CEO of health and local care indicates that these network services are already being considered with aggregation in mind.

Andrew Turner, information infrastructure manager at NHS Dumfries and Galloway for the NHS in Scotland, said: "You have far more cats to herd in the UK. We only have one network provider in Dumfrees and Galloway. There are fewer trusts and fewer providers. It is easier to aggregate."

Simon Norbury, PSN local government transition at the Cabinet Office, explained that the government is working to help resolve some of these issues around governance, but that there was no one person or body in charge of telling local authorities what to do, and that health at the central government level was exempt from Joe Harley's mandate to make use of the PSN.

He also said he recognised there were legal, assurance and contractual issues that were stalling aggregation, and that he was working to resolve these.

"I'm a pragmatist. The NHS trusts will be PSN-ready and so will likely be able to join over time. I believe the PSN will be a success in a series of small steps," he said.