Connectivity between the Health and National Education &

Research Network in the UK TERENA, Bruges

May 2008

Malcolm Teague, JANET(UK)NHS-HE Co-ordinator

Malcolm.Teague@ja.net

NHS-HE Connectivity Project

Objective: ”To achieve good inter-operability between

NHS and Higher Education (HE) networks that enable secure anytime, anywhere access by medical, nursing and allied profession students, clinical teachers and researchers”

www.nhs-he.org.uk

To move away from “2 PC syndrome”

Overview

• Context: Health NREN Network infrastructure models

• Experience to date with the early adopter N3 JANET Gateway, and plans for the future

Network Infrastructure:Some National Models

1. “Health” and Education & Research use the same network, security in applications eg Denmark http://www.terena.org/events/tnc2006/programme/presentations/show.php?pres_id=305

Use of Connection Agreement System….

Unitary Authorities Tier 2: own MPLS layer

NHS Tier 3: own MPLS layer

Possibly Welsh Assembly in future

Education & Research (JANET) Tier 1: IP Layer

2. “Health” and Education & Research use the same network, but in different network tiers eg Wales public services broadband aggregation network (being implemented)

Interconnectivity still needs to be achieved

National Models contd.

3. “Health” and Education & Research use different networks, security partly in network, but mostly in applications eg England, Scotland, Sweden, many others (especially if include Regional health networks)

4. As above, but with Education & Research networks extended to key “Health” sites eg Italy, Brazil

National Models contd.

5. “Health” uses a mixture of public and commercial providers with no national grouping, NREN for Education & Research eg Belgium, USA, Canada

Scotland

EnglandWales

Northern Ireland

Countries of the UK

Health (and social care) policy is the responsibility of the devolved administrations in Scotland, Wales and Northern Ireland

Health Network in England & Scotland (N3)

N3 Goals (the New NHS National broadband network)

Broadband network linking 20,000 sites in England, up to 3,000 in Scotland and 10,000 non-NHS Enabling key NHS applicationsOne of the largest VPN networks in EuropeExpected savings c£900m over seven yearsServing one of the World’s largest employers – 1.3m

N3 Service Provider

BT fulfilling a network aggregator role 4 years into 7year contract58 PoPs and 12,780miles of Fibre to date400 People employed within BT

Slide adapted from John Hemsley, BT

Wales

Scotland

England

Northern Ireland

N3 – Enabling the NHS National Programme for IT

Electronic Transmission of Prescriptions

Picture Archiving & Comms Systems

.

NHS Mail

NHS Care Records Service

Choose & Book

Slide adapted from John Hemsley, BT

(England)

N3 JANET Gateway

Experience so far in an health and education & research interconnectivity project in England and Scotland

N3 Scotland

JANETGateway

N3England

Scotland

England

Wales

N Ireland

NHS Wales

Health & Social Services in NI HSCnet

N3, NHS network in England and Scotland

Internet

N3, “by invitation only” but considered “hostile”

N3 JANET Gateway Objectives

to build a gateway for “early adopter” useselected projects as pathfinders

to analyse traffic crossing the gatewayamounts, and types of use

to demonstrate practical collaborationsestablish that investment was worthwhile

to prepare a case for a permanent gatewaysized and operated appropriately

Physical gateway

connect JANET backbone & N3 core

IPSFirewall

single 100 Mbps interconnection in London (Kingston Exchange & Telecity)

Today

• Gateway infrastructure in place early November 2007 (clock ticking on 1 year contract)

• Traffic is passing for 4 early adopter communities – some diverted from N3 Internet Gateway and some “new”

• Sessions initiated in N3, “Any N3” through “Any port” but to early adopter IP addresses only

• Tandberg Expressway in place and about to be commissioned (for H.323 videoconferencing as part of Janet Videoconferencing Service, JVCS)

Early adopters

• CETL4HealthNE: University of Newcastle with University and NHS partners in NE of England

• University of Bristol & University of West of England & Clinical Academies at NHS Trusts

• University of Birmingham – primary care research• Wellcome Trust Sanger Institute – chromosome anomaly

database

And soon…• JANET Videoconferencing Service (JVCS)• University of Edinburgh • Interested in others

Information Governance (England)

• NHS “Statement of Compliance” (SoC) emerged: organisation’s self-assessment against a set of standards, with potential for audit.

• SoC for JANET(UK) as the aggregator• SoC for each University as an early adopter?

Agreed not for the initial set up………as long as no patient identifiable data (PID) involved……then agreed that not needed for any sessions initiated in N3.

Now: Sessions initiated in N3

Sessions initiated in:

N3 JANET

No PID

PID

Now

Eg access to VLEs

Eg collecting research data

Investigating:

Eg NHS intranets

Access to NHS clinical systems

PID = Patient Identifiable Data

N3 JANET

Gateway

NHS, N3 Education & Research, JANET

User

Sessions initiatedin N3

Eg Secure web access research database

Responsibility is with the organisations involved and research ethic committee approval

Next 1: Sessions initiated in JANET; no PID

Sessions initiated in:

N3 JANET

No PID

PID

Now

Eg collecting research data

Eg NHS intranets

Access to NHS clinical systems

N3 JANET

Gateway

NHS, N3 Education & Research, JANET

User

Next 1: Sessions initiated in JANET; no PID

NHS Trust intranet, or licensed knowledge resources

Proxy Server

Is there a need for this or is IP address authentication likely to disappear?

Next 2: Sessions initiated in JANET: PID involved

Sessions initiated in:

N3 JANET

No PID

PID

Now

Eg collecting research data

Eg NHS intranets

Access to NHS clinical systems

NHS staff needing access from JANET for NHS work

University Research staff needing access to PID for research (with ethical approval)

Next 2: Sessions initiated in JANET; PID involved

• Not so much the connectivity…• The authorisation and authentication is the

key• NHS in England have role based access

linked to smartcards• And VPN with secure token via internet• Investigating how these can be used from

JANET+ NHS now have a research capability programme to look at improved mechanisms for accessing clinical data for research

Summary for Gateway• Evaluation now, creating the business case for

after the year +. The main drivers include:– health research competitiveness

– Increased numbers and healthcare involvement in health teaching, across whole NHS, integral e-learning

– Creation of Academic Health Science Centres eg Imperial

• More early adopters and use cases• Action learning for all parties. Helping to generate

policy and tools. Building trust

and support from the NHS

Conclusion

• Could we do a “Denmark”? Not in the medium term – but might share more

• Can we use the same Gateway approach for other public service networks? Depends on their security model, not for current UK government secure intranet

• Isn’t the internet sufficient? Not at the moment

Thank you

Malcolm.Teague@ja.net

www.nhs-he.org.uk