1. 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

2. 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”

3. Overview Context: Health NREN Network infrastructure models Experience to date with the early adopter N3 JANET Gateway, and plans for the future

4. 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 http://www.terena.org/events/tnc2006/programme/presentations/show.php?pres_id=305 Use of Connection Agreement System….

5. 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

6. 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

7. 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

8. Scotland England Wales Northern Ireland Countries of the UK Health (and social care) policy is the responsibility of the devolved administrations in Scotland, Wales and Northern Ireland

9. 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 applications One of the largest VPN networks in Europe Expected savings c£900m over seven years Serving one of the World’s largest employers – 1.3m N3 Service Provider BT fulfilling a network aggregator role 4 years into 7year contract 58 PoPs and 12,780miles of Fibre to date 400 People employed within BT Slide adapted from John Hemsley, BT Wales Scotland England Northern Ireland

10. 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)

11. N3 JANET Gateway Experience so far in an health and education & research interconnectivity project in England and Scotland

12. N3 Scotland JANET Gateway N3 England 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”

13. N3 JANET Gateway Objectives to build a gateway for “early adopter” use selected projects as pathfinders to analyse traffic crossing the gateway amounts, and types of use to demonstrate practical collaborations establish that investment was worthwhile to prepare a case for a permanent gateway sized and operated appropriately

14. Physical gateway connect JANET backbone & N3 core IPS Firewall single 100 Mbps interconnection in London (Kingston Exchange & Telecity)

15. 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)

16. 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

17. 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.

18. Now: Sessions initiated in N3 Sessions initiated in: N3JANET 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

19. N3 JANET Gateway NHS, N3Education & Research, JANET User Sessions initiated in N3 Eg Secure web access research database Responsibility is with the organisations involved and research ethic committee approval

20. 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

21. N3 JANET Gateway NHS, N3Education & 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?

22. 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)

23. 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

24. 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

25. 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

26. Thank you Malcolm.Teague@ja.net www.nhs-he.org.uk