Connecting for Health fails to lead on Contact

Tags: Budget CfH GP Granger Informatics Information iS Kingston Microsoft NHSmail Savings Servers Wireless Wirral

25 Apr 2006

NHS Connecting for Health continues to run its own local version of Microsoft Exchange rather than migrating to NHS Contact, the web-based e-mail service it procured for the health service at a total cost of up to £90m.

At Healthcare Computing 2006 last month CfH chief executive Richard Granger castigated NHS trusts for not fully migrating to Contact and switching off their local email systems.

Referring to recent reports on the financial pressures faced by NHS trusts he said trusts should make full use of products that had already been bought for them and not unnecessarily duplicate costs.

Granger said: "Why not take this email service and turn yours off locally?"

However, it turns out that CfH is failing to lead by example and continues to run its own Microsoft Exchange email servers. The agency was unable to tell EHI when it plans to fully move to Contact and make savings by switching off local email systems.

CfH said the email migration was "highly complex". To date just 80,000 NHS staff members are regular users of the service.

The agency declined to say how many of its staff use Contact as their main email service, and in response to questions on when it would migrate to Contact said: "NHS CfH is in the process of migrating from the Microsoft Exchange service to the Contact service, at which point all NHS CfH staff will be daily users of Contact."

The agency was unable to say when this would occur: "The migration will occur over time; the date of the complete migration will be published when all the technical and business issues arising from a highly complex email migration have been resolved and planned to ensure continuity of service for NHS CfH users.

CfH was also unable to put a price on the cost of running its own email, or on how much it could save by migrating to Contact. "Detailed costs of running the email service is not currently separated from other IT support costs."

The overwhelming majority of NHS and CfH emails routinely seen by EHI do not carry the tell-tale nhs.net suffix used by Contact, but instead carry other naming conventions indicating they come from local email systems.

CfH failed to identify a single NHS trust that had fully migrated to the web-based system but said that it was "in the early preparation stages of work with a number of acute trusts, for example, Wirral Hospital NHS Trust".

The agency told EHI that its Contact team "are currently focusing in migrating PCTs to Contact", and named Kingston PCT.

However, Geoffrey Pugh assistant director for informatics at Kingston PCT, told EHI that the organisation was introducing Contact swingeing budget cuts to achieve financial recovery meant "there is now no specific timetable or plan".

"Many staff have taken up the option of Contact and run it as a parallel email, but we've got no real project to completely switch to it, as we're in survival mode," said Pugh.

In a statement the agency said some PCTs "have fully migrated parts of their organisation, for example GP practices, and decommissioned local email exchange servers". It added: "There are thousands of exchange servers within the NHS, and many organisations have a server for each GP practice or site."

According to CfH there are now 163,000 registered users of Contact, 80,000 of who are described as "frequent users".

In a bid to bulk out these registration numbers CfH has announced that all 400,000 members of the Royal College of Nursing working within the NHS, including agency staff, are to be bulk-registered automatically registered on Contact. But while the increased numbers are certain to look good in reports back to ministers, bulk registering staff for a service is very different from getting them to use it.

One of the key advantages of the web-based Contact system over regular email is that it encrypts all messages sent across it, enabling it to be safely used for clinical correspondence.

In 2002 the NHS Information Authority awarded a £90m contract with Electronic Data Systems for a web-based NHSmail email service, but six months after its launch just 25,074 NHS staff (then 2.3%) had activated an account.

NHS Connecting for Health subsequently terminated the contract with EDS, which involved paying EDS £9m in compensation. In 2004 CfH then awarded a new contract to Cable and Wireless for a replacement web-based email service called Contact. The contract was worth an initial £29.5m, rising to £50-90m when a planned number of users sign up for the system.

Readers Comments

The problem is around functionality

25 Apr 06 14:06

As with most of the CfH products, contact provides less functionality than what we already have, as provided by our local exchange service. Particular areas of concern are calendaring, the ability to use Blackberries and niceties like the Out of Office assistant.

Leading from the ....?

26 Apr 06 15:05

Sign an enterprise-wide agreement for Documentum, then use geek's favourite Plone for websites; sign an agreement for Sharepoint, but use the utterly God-awful FileCM internally; tell the NHS to use Contact, but continue to use Exchange Server. Anyone see a pattern?

Good to see that inside CFH we can still exercise some independence and avoid anything that smacks of ruthless standardisation. For our next trick, maybe we should migrate to Linux and some open source desktop software.

Nothing like stds

26 Apr 06 16:56

Last time I was in a CfH office in Richmond House, I saw Lotus Notes Hooray - cos I use it also and its up more than microsoft products and has more functionality. Here is where we now start the war on what email package, like Apple macs v PC debates. Cant wait, lets use some eheath Insider disc space.

Make a decision Mr G.

27 Apr 06 07:47

Now would be a good time for Mr Granger to mandate Contact/NHSmail. We have numerous new organistaions being created up and down the country SHA's,PCT's, Mental Health trusts,Ambulance trusts. Please force them down the Contact/NHSmail route to save us from having to create stupid options apparaisals to justfy the spending of hundreds of thousands.

From a regular Contact email user

27 Apr 06 20:27

I use Contact as my regular email account (over 50 emails per day) and I am very happy with the service, the help desk is good and when I have had queries, they have responded promptly. I was able to configure Outlook as my email client using the instructions in the web based version. I only use the web-based version when I am abroad or if I want to send SMS messages. There is also a facility for out of office and forwarding. I am very happy with the service.

Contact and spam

mary.hawking@nhs.net

27 Apr 06 20:47

I have a Contact address - and use it to forward email to my practice MTA where I have Outlook - and problems. Junkmail. I asked Contact about putting in a junk mail filter: I was told they can't, because it might take out a clinically important legitimate email. I can't get my Outlook to run in cached mode - and so can't put in a filter there. Suppose someone got Contact to function acceptably?

There *has* to be something wrong with a service which is offered free to the organisation - and still is not used...

Deja Vu

andrew@garcarz.net

28 Apr 06 00:35

On the Contact service. To send an e-mail between departments in the same building the message must pass through the central Contact mail server and back to the trust, using precious N3 bandwidth and potentially putting all trust communications at risk if the link fails. Multiply e-mail use by two or three thousand seats for a large trust, and assume that most messages contain attachments such as minutes of meetings, holiday snaps and MP3 files and calculate the volume of traffic passing across the network, and if you are an IT manager in a trust, ask yourself is this a valuable use of your network resources and the answer is almost definitely no.

When the EDS service was introduced the perception was that this "Hotmail" type service was OK for GP's and small organisations that lacked sufficient IT skills to manage a mail server but ludicrous to expect a large trust to want to have to pass every single message to the central mail service.

Its horses for courses, but once again CFH acted without seeking the advice of the people who knew about this sort of thing; but congratulations to CFH's IT Team for resisting the unnecessary migration to Contact. By the way, the Contact service is not just a web based mail service; an SMTP mail relay is part of the contracted service, which was designed to replace the previous SMTP service run by Syntegra. So it seems that CFH must have known that there will always be a need for server/relay based mail distribution.

Coming full circle...

jon@e-health-media.com

28 Apr 06 09:24

Just to confuse/clarify/mystify matters further E-Health Insider has learned that Contact - the service previously known as NHSmail while being provided by EDS - is to have its name changed again to err NHSmail.

Are there perhaps a surfeit of marketing and branding staff being employed by Connecting for Health (previously known as the NHS National Programme for IT)?

Windscale to Sellafield - what are name changes intended to do?

28 Apr 06 11:02

NPfIT qualifies its programme name as Connecting for Health (already in use by someone else) then decides to change names from Contact back to NHSmail (are we sure it too is not still copyrighted elsewhere?) and I hear rumours that we are also to be instructed to refer to NPfIT as NPFIT and CfH as CFH -- all very 'resourceful' actions, suggested perhaps by resource-guzzling PR/marketing companies? but we really have to ask what is gained by this except perhaps entries in the spoof columns of the trade press. I look forward to the answers!

Some comments

30 Apr 06 19:01

I have used NHSMail/Contact/NHSMail on a daily basis since about October 2004. It actually provides quite good junk mail filtering and out of office replies in my experience, and connecting it to an email client like Outlook is trivially easy.

However its calendaring functionality is sub-par. I've not yet managed to connect my NHSMail calendar to Outlook despite reading a 45-page PDF on the subject.

Re. NHS CFH's internal systems. Documentum and Plone are quite different systems that solve somewhat different problems. Plone is used by several NHS organisations (NHS CFH included) because it provides a set of tools to build an accessible website, relatively quickly and at relatively low cost. There are no "official" NPfIT systems for doing this that I'm aware of. Documentum is more focused on document management. In this case at least, there's little functional overlap.

Missed opportunities

02 May 06 10:24

The view that Documentum is mostly a document management tool may have been true a few years ago, but not anymore. As a suite of products, it offers a lot of potential for joining up web content management and document management across the organisation. Lest I sound like an ad-man for EMC, there are other commercial products that will do the same thing. Within CFH we're currently faced with a range of poor and fragmented systems.

OK, Plone is good on accessibility, but it's content management interface is poor and the implementation for the CFH Intranet is clunky. It doesn't integrate with document management for which we have FileCM, possibly the worst piece of software I've ever had the misfortune of using. EWIP? - don't even go there.

CFH would have a far stronger case for recommending its enterprise-wide agreements if it was seen to be using them internally in an integrated fashion. Instead, we're a microcosm of the wider NHS as individual departments choose 'pet' bits of software without any thought for the end users or wider integration. Where's top-down management and ruthless standardisation when you need it?

Documentum and Plone

02 May 06 12:14

While not wishing to sidetrack the discussion, I think it's important to note that Documentum does not provide tools to manage a website out of the box (in the sense of page templating systems etc). It's necessary to still build/bolt these on. I can't speak for NHS CFH, but I know that while at Surrey HIS we discounted the use of Documentum as a Web CMS for this very reason (in favour of Plone). It's in this sense that I think the comparison between Documentum and Plone is flawed.

However I emphatically agree with the general idea that it's healthy for an organisation to lead by example. Also, this tends to ensure that issues are spotted before systems are rolled out to a wider audience.