Advantages and disadvantages of NHSnet

The advantages of using the NHSnet based service are:

• Security: it is a managed secure network. Internet links go through a secure gateway protecting you and the network from virus infection and hackers
• Access to X.400 e-mail users i.e. most of the NHS
• Access to NHSnet based services and information that is not accessible from outside
• Internet access for e-mail and web sites. The gateway has a mapping of X.400 addresses to the internet addresses for e-mail (i.e you have both an internet address and an X.400 address for the same message store).

Disadvantage:

• x.400 and internet NHS e-mail addresses are long and complex compared with the relatively neat mailbox addresses we're used to on the internet.

What's on the NHSnet?

Web-wise there is not much available within NHSnet, but what there is, is good:

• The most useful site is the NHS Information Zone, which is packed with useful sub-sites for clinicans and managers. This gives direct access to press releases and circulars weeks before a practice receives the information via the health authority. The Information Zone contains clinical, executive, IT and news zones amongst others; it has search utilities; access to medical libraries and discussion zones. Plus there are numerous links to useful Internet sites. There is one site called MIRON (Medical Information Resources on NHSnet) that offers search utilities and from which medical information CDs can be obtained
• Other NHS Intranets at Trusts and health authorities are generally accessible
• As a Sheffield based NHSnet user we have access to a Sheffield Natural Community web server based (X.500) directory database of Sheffield NHS personnel, including all general practices. A powerful search utility allows individuals or organizations to be located from several different attributes - e.g. name, job title, function, department, location etc. As part of a pilot this directory sevice is integrated with our e-mail, such that e-mail addresses are pulled from a central directory database.

When using the NHSnet you are not normally aware whether you are at an NHSnet site or an Internet site, since you move seamlessly between the two. The NHSnet site addresses are generally prefixed with nww rather than www.

How do you join the NHSnet?

The main issue is one of compliance with the security standard of the NHS Code of Connection, which is quite rigorous. This should be complied with by any NHS organization, including general practice, where a link to an external network exists - Internet or NHS net. The first step is to undergo a security audit, which is presently carried out by NHS Telecoms Branch. The essential elements of this are:

• Evidence of a security policy, preferably written
• Backing up procedures
• Password protection and password changing
• Physical security of the building
• Physical security of work stations, servers and data storage media
• Control of access to data
• Virus protection

The Telecoms Branch or health authority IT personnel would be happy to guide you through the process of linking up.

References and further reading

• NHS Telecoms Branch for security audits and other information
• Code of Connection written for "IT aware GPs"! Lots of notes on strategic aims, technical issues, confidentiality etc.
• Rethinking NHS networking (BMJ article)
• Radical reform of NHS information strategy on the way (BMJ news item)
• Patient data, confidentiality, and electronics (BMJ editorial)

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