NHSmail users have mailbox shrunk

06 Feb 2008

NHS staff who use the health service’s email service NHSmail have been informed that after a recent move to Microsoft Exchange their mailbox size has been capped.

Some 80% of NHS accounts have been capped at just 200Mb, which appears miserly compared with the hefty 6Gb offered by Gmail for free, or the 5Gb offered for free on Windows Live Hotmail.

Quotas were imposed on the size of all NHSmail accounts at the end of 2007. CfH says the quotas have been automatically assigned “based on actual consumption”.

CfH says the quotas have been set at the following levels: 2% have been set at 1Gb, 3% at 500Mb, 80% at 200Mb and 15% at 50Mb.

Under the previous version of the NHS’s email system, based on a system called Mirapoint, there were no limits on mailbox size. The new quotas have been introduced as part of the migration to Microsoft Exchange.

Cable and Wireless, the company responsible for delivering NHSmail for the past three years, announced in July 2007 it would switch to Microsoft Exchange 2007. By the end of 2007 there were estimated to be 180,000 active users of NHSmail, out of an NHS workforce of over 1.1m.

In a statement to E-Health Insider, CfH said the quotas would allow the system to operate at maximum efficiency and “ensure that budget can be better spent on other areas”.

The agency took issue with comparisons to free commercial email services: “NHSmail is not a consumer service (such as Hotmail) and therefore must not be compared with them. Prior to the introduction of inbox restrictions, the NHSmail team conducted research into public and private sector email services and found that across comparable services, the average inbox restriction was 150Mb.”

Asked by EHI why the rationing of mailbox size had been introduced, CfH said that it believed predictability was more important than encouraging use of the service. “Quotas help in two ways. A known quantity of data to migrate to the new service helps facilitate a smoother migration process and quotas enable the new service to be designed in a reliable way without the need to guess consumption growth.”

Asked whether individual users would be able to appeal their allocated mailbox size, CfH said the quotas would be fixed for the time being: “As the new Exchange service beds in and its usage and performance characteristics are understood we will look to increase the quotas. Until then the quotas are fixed.”

Reader's Comments

whoops!!

06 Feb 08 13:05

I've just checked my (non NHS) mail file forder and have almost 2Gb of info in it - doesn't look like I'd be accomodated by NHS mail then. I'm not a huge email user, but do get lots of stuff from CfH, LSP's etc

Of course, i could go through them all and delete the unnecessary, but I don't get time to check what I need to keep, and what I can discard. Maybe if I print..............!!!

Path slides are huge

hilary@regordane.net

06 Feb 08 14:57

I have a Powerpoint presentation which is 32 Mb because of the histopathology images it contains. It had to be circulated by email to NHS and non-NHS personnel on the clinical audit group I work with. Ok, the pathologist who provided the images could probably argue for a bigger mailbox but what about the other poor folks who need to receive a file like that without warning? Yes, I know it should be downloadable from a web portal (indeed, it is) but you try getting the average clinician to look at committee papers that aren't actually attached to the email notification of the meeting.

Mailboxes... what about pst's

derek.prudhoe@nhs.net

06 Feb 08 15:59

Any organisation which is considering moving to NHSmail not only has to think of mailbox size, but also any archived email stored in pst's - I know of one person in our organisation with over 10Gb of archived email.... How will this be catered for? We keep our user's accounts down to a manageable size by promoting the use of pst's... Also, if the data is stored by C&W how quickly can a FOI request be processed?????

right tools for the job

06 Feb 08 16:47

I'm sure lots of people on this forum have lots of very important stuff that they have received via email, but I'm confused as to why people think this is the best way of storing it. Surely you don't file all your documents in your email? Am I the only person that only keeps what I need and saves email attachments to a backed-up drive?

Powerpoint Bloat

06 Feb 08 16:51

If you are using Powerpoint 2003, you can use the feature to 'compress' (actually producing reconfigured images) for a version of your presentation suitable for screen display rather than printing. This should make your file much smaller.

re: NHSmail users have mailbox shrunk

06 Feb 08 16:55

As a regular reader of EHI, I am disappointed to see that yet again you have misreported a news item!

Firstly, the NHSmail platform hasn't yet moved over to Microsoft Exchange. This is scheduled (I think) to happen in the summer.

Secondly, you really can't compare commercial profit generating operations such as Gmail et al with the likes of Enterprise class systems such as NHSmail. Gmail and co dont have to provide SLA's, backups or helpdesk functionality. They have security issues (an example - http://www.theregister.co.uk/2008/02/01/google_ssl_sidejacking/) and generate revenue from advertising. Does the NHS really want all this in return for bigger mailboxes?

At a current cost of around £160 per Gigabyte of useable secure, resilient, backed up, supported enterprise class storage (as a tax payer) I for one am glad the quotas have been introduced. Money saved by making people store data in the correct place (document management systems etc) can now be spent on other NHS resources. After all, E-mail is a transmission medium, not a storage one.

I am looking forward to the move to Exchange and the benefits it will bring to the NHS. And who knows, we may see the quotas increase once the new NHSmail system is in place.

Are you going to suggest in your next article that the NHS should now move to Google Docs and dump the Microsoft EWA??

£160 per GB?

06 Feb 08 18:44

Actually Google does offer an enterprise class product for $50 per user per year (URL below). It includes a range of services and 25GB of storage. That works out at about £1 per gigabyte. And I'm sure they'd provide Open Office for free!

http://www.google.com/a/help/intl/en/admins/editions.html

Generic Mailboxes

grant.forrest@nhs.net

06 Feb 08 20:37

We use an NHS mail Generic Mailbox (GM) to take referrals from community-based Optometrists. The Optometrists attach digital retinal images which are about 2-4Mb per image (JPEG or DICOM): sometimes there are 2-3 images per referral. Out LOA asked for a quota increase because the GM was approaching 200Mb, which is about 50 referrals. The request was denied and we now have to archive referrals on a weekly basis which you might argue is good practice, but it would be nice if we could have a 2Gb quota and do the archiving monthly. It isn't clear how GMs are going to be implemented on the MSExchange platform, but I'm just reporting this as a warning to those of you that actually use NHS Mail for "clinical" purposes. P.S. 32 Mb Powerpoint file attachment - I would be using some choice language if I found that in my Inbox.

All very well but ...

hilary@regordane.net

07 Feb 08 10:29

I'm well aware that there are much better systems than email for handling large files. Who is going to train the clinicians to use them? And who is going to set them up in ways that allow for collaboration with colleagues outside the NHS when this is appropriate (and not when it isn't).

I'd be annoyed too if anyone I considered IT literate sent me a 32 Mb attachment. However, in my experience clinicians who fit that description are few and far between, and email is the way my NHS colleagues expect to receive information from me. And why does a professor of histopathology not know how to compress a Powerpoint 2003 presentation? I admit I didn't know that either, but using large images is central to his work which it isn't usually to mine.

Gmail? Seriously? the tabloids would LOVE that.

07 Feb 08 11:32

As a tax payer I would be furious if I found out that the NHS was planning to spend $15'000'000 (£7million) a year on an email system (Google) that wasn't secure, doesn't send SMS ( a feature of NHS Mail that our practices use all the time to great effect), or faxes, isn't locally hosted and subjects me to adverts every time I log in just because some people can't follow good practice and common sense. Email is there to send and receive email. Period. It is not there to store stuff. I don't expect the postman to provide me with lever-arch files, filing cabinet and a study to store all my post in, so why should NHS Mail provide us with a place to store our electronic post. Nor should NHS Mail be blamed for the poor working practices of clinicians who won't look at papers simply because they aren't attached to an email. Locally ( and I’m sure across the board) we've had lots of pressure from above about the secure transmission of data following the recent 'lost data' issues in the news. NHS Mail has to be an obvious solution for most of us. From an Information Management point of view, we have a nightmare whenever someone leaves making sure that they have handed over all 'useful' and necessary files that are hidden in their email accounts. Hopefully the quotas might mean that people save attachments in a more sensible place in the first place making mine and my colleagues jobs much easier in the long run Quotas are a normal example of good working practice. We just need to get used to it. One of the newsletters that the NHS Mail people sent out months ago predicted that storage costs for the next 12 months would be about £3’000’000. That’s an outrageous waste of taxpayers money that can mostly be avoided.

Look after your own email

07 Feb 08 20:22

1. Another reason to use a program such as Pegasus, which downloads & deletes messages as required, allowing non-deleting access from home (effectively) unlimited record storage at work while not cluttering mailservers in the long term? Another advantage is that these are less prone to virus writers than Microsoft products

2. Recipient limits, preventing receipt of essential large files, are a concern

3. On a more positive note however, perhaps this may reduce the unquestioning incorporation of logos in email attachments - it is not unusual for Trust logos to inflate simple 10Kb letter files to several Mb . . .

No service

08 Feb 08 09:05

I was appalled when CfH cut the size limit of a generic mailbox that i had set up to receive a large amount of data from 500gb to 200mb, a cut of 99.6%, and then refuse to even consider increasing the limit. The reason why there was no limit previously was for clinical safety- that idea seems to have been thrown out of the window. If you point out that 'free' services such as Gmail offer much more, they point out the lack of control and support that these services offer - In my capacity as an LOA for NHS Mail, I have to say that there really is no support given by Cable and Wireless or CfH. Problems with the service are inevitably your fault or a feature. Our Trust considered moving our entire email to this system, but was frightened off by the lack of service and the lack of control that it would offer. Some areas of our Trust offer limitless inboxes. I am now in a position where I have spent money to set up a project using NHS Mail, but now have to rethink the whole scheme due to massively unrealistic limits set by CfH. There are ways around this (setting up more accounts to increase the storage limits), but they impinge on the usability. Thank God our Trust didn't adopt this system! My main gripe however, is that millions have been spent developing this system, only for it to be changed yet again to an off the peg MicroSoft product. What a waste of money and effort. Perhaps once the new system is up and running, and a genuinely usable system is in place with service provided, there will be a real shift by the NHS to use it. But I won't hold my breath.

Greed!

08 Feb 08 09:57

Kind of explains it all .......

Fixed quotas

09 Feb 08 09:16

No risk of CfH learning customer focus then. Just stop any adjustments to mailbox quotas for the next six months whilst we let Microsoft take over.

Given the current national focus on security of messages, a more NHS focussed approach would help draw people into the service rather than push them away to local alternatives.

What is the problem?

12 Feb 08 08:08

Your email is for messages it is not a file storage area. People have been using it as such because they cannot basically in the main be bothered to use it properly and delete unnecessary messages e.g. your mates sending round jokes.

For 90% of the users 200Mb is more than they will ever need, for others they have already agreed that once everyone is down to a manageable limit then they will increase some accounts that have to hold large amounts of data as that is what their job entails. It should be made clearer to the account users though that the email should not be used as a storage area that is what local servers are for or external hard drives but the users should be sorting out storage not relying on NHS Mail to provide cheap and easy options for them.

Previously one comment was made that they were going to use NHS Mail for holding 500Gb of email....why?

A better alternative.

12 Feb 08 09:36

Can I recommend a much better alternative - the DNUK secure email site? This provides a secure, locally hosted, virtually spam-free and highly efficient service which has never given me cause for complaint. On NHS mail, the vast level of spam makes their low capacity incompatible with real life usage. http://www.doctors.net.uk/

Problem? No Problem

ken.scott@nhs.net

12 Feb 08 10:09

Having read all of the previous comments I can appreciate why some people have concerns, but in reality the real issue is a one of training. People should be trained on how to use email properly. Perhaps if some of the £3m that was mentioned it would cost for storage was spent on training there would be no problem.

Don't get me wrong, my colleagues and I use the system to send some rather large files, manuals, guides, etc. so need the 'transfer' ability but once recieved the attachment is saved accordingly. Used in the manner an email programme is intended to be used then NHSMail is a great system.

Email as opportunity rather than problem?

12 Feb 08 10:37

The discussion shows the extent to which users rely on email to transact business on a day to day basis, not least because of its flexibility in storing message and attachments in the same place where they can be searched by date, sender, keywords.

The self discipline of those who separately archive attachments is to be applauded but I'm not convinced that it is something the average user should have to do under duress, particularly given that the cost of hard disk space continues to drop.

Surely there is a way of managing email storage without compromising the usefulness of email by imposing arbitrary limits? Is there an opportunity here to look at ways of integrating a better method of managing attachments within the email system?

An Alternative.....

12 Feb 08 10:47

www.doctors.net.uk - is it really better????

It's probably very good for research and personal/non-clinical mail in the same way Gmail and Hotmail are. (I can't use it as I am an IT manager in a small trust and not a GMC member), but at the end of the day it's another commercial e-mail system with ads etc. You surely cant be suggesting it be used for clinical data transmission or for enterprise use in the NHS? It just doesn't have the credentials

Read the T&C's very carefully.... "Doctors.net.uk also reserves the right to introduce charges, terms and conditions relating to the payment of those charges, and to review and amend charges for access to this Site and the Doctors.net.uk services"

"Doctors.net.uk reserves the right to remove the contents of your e-mail account if you have not used the e-mail facility for 90 consecutive days or more."

"Doctors.net.uk aims to make this site and Doctors.net.uk services available 24 hours a day, seven days a week, but reserves the right to suspend access to this site and any or all of those services at any time, without notice, for maintenance purposes...."

"The Bulletin may contain the following types of information: .... ....pharmaceutical companies, financial services companies and medical indemnity organisations"

"No warranty, representation, or undertaking in respect of the quality, or fitness for purpose of any content or any service is given...."

"Loss, destruction or corruption of data..."

A better alternative.

12 Feb 08 10:56

Well, having used both NHS mail and DNUK every day for two years, I gave up using NHS mail because DNUK was so much more functional, so much more reliable and had so much less spam. Try it before you knock it!

alternative

12 Feb 08 11:12

Did you actually read my post? I didn't knock DNUK! (I cant register to use it so I have no persoanl point of reference there). I questioned its validity as an enterprise class e-mail system for the NHS. It probably is a valid alternative (as are Gmail etc) for personal use, but nothing further.

A better alternative.

12 Feb 08 11:46

Yes, I did read your post. My point in response to it was that having had comparable experience of both, I have found DNUK much better. I know many other DNUK users who take the same view.

'Proper' use of email

12 Feb 08 22:30

Several comentators state that users should use email 'properly'. But just who are they to dictate 'proper' use? Email is a tool. It should be for every user to make the best use of it for their purposes. Often the email message and the attachment are intimately related and to archive the attachment and delete the email destroys the context, and makes the document much less easy to search for. And email remains accessible from multiple sites, unlike my work PC. So if CfH offers me a useful tool then renders it useless to me then that's alright is it?

For goodness sake

13 Feb 08 08:00

Well I think AOL mail is wonderful but that does not mean that it's suitable for work. DNUK is a private email system and therefore not controlable by the NHS. NHS Mail was set up to enable organisations to have an email account accessible anywhere in the country/World. It's secure and approved for transferring PID that is what it is there for. Not all NHS organisations have the time nor the funding or the ability to look after an exchange server e.g. GP's.

People keep banging on how it's not as functional as this that or the other service. I mean come on it sends and receives email, you can store 200mb of stuff which is enough if you actually delete the rubbish out. (The I don't have time excuse really does not wash it's just a person's bad time management) if you really need it then save it properly. You can use it with Outlook if you are really desperate and for some unknown reason cannot manage an online email account, funny how no one ever complains about other online email accounts which lets be honest don't have any more functionality.

I honestly believe most people complain for the sheer heck of it and the fact that it's provided by the NHS and even if it was the best system in the whole wide world they would still find fault.

Competitive?

20 Feb 08 10:15

"I honestly believe most people complain for the sheer heck of it and the fact that it's provided by the NHS and even if it was the best system in the whole wide world they would still find fault."

Perhaps this attitude to customers helps to explain the lack of clinical involvement in so many centralised NHS IT programs and their lack of ultimate customer satisfaction. In a competitive environment it is unlikely to survive.

No Competion

ted.yeoman@nhs.net

20 Feb 08 12:05

Taking on board fully the comments about clinical engagement ... the central issue NHS Mail is very competative. Where else can you get a certified totally secure (well almost) Hack proofed, virus scanned email service? With 200 Mb of equally secure storeage for nothing ? Free Help and support?... All the free on line mail services fail these tests except NHS.net. It ain't perfect but it is a highly competative offering

Attitude

22 Feb 08 08:51

"Perhaps this attitude to customers helps to explain the lack of clinical involvement in so many centralised NHS IT programs and their lack of ultimate customer satisfaction. In a competitive environment it is unlikely to survive."

Please explain why you need clinical involvement on an email system. Clinical staff seems to cope fine with all other types of email what is the difference with NHS Mail. You can write, send, receive and store data. It’s also not an attitude to customers it’s just the truth and I use NHS Mail daily so for me it’s not an IT thing it’s just a that people like to complain about services provided to them. I can’t wait to see if the moaning stops after NHS Mail starts using Outlook.

I’m going to bet it doesn’t.

NHS Mail Problems

12 Mar 08 17:31

I remember when we originally used Outlook for emails, so I was confused when we moved to NHS Mail and are moving again to Outlook. Expensive exercise. As for those who have mentioned that if you just keep your mailbox within a reasonable size then everything will be fine, may I remind you that if the PCT send you a large email with attachments this may block you from your own account. Should we be telling PCTs not to send large attachments, or should NHS Mail start communicating a little bit better? I recently contacted NHS Mail with regards to these issues and they just did not want to know. Maybe NHS Mail should ask it's users what they need and cater to these needs. Sure, not everyone will need large mailboxes, but if you're trying to save paper and memory on your own hard drive, and trying to juggle multiple job roles you may need more mailbox space to deal with this. Hopefully, Outlook will cater to our needs, seem to work perfectly well last time around.