Internet First

NHS Digital (NHSD) was derived from one key statement made by Matt Hancock, Secretary of State for Health and Social Care. He said, “we need to take a radical new approach to technology across the system and stop the narrative that it’s too difficult to do it right in health and social care.”

NHSD introduced an Internet First policy in March 2018 to fall in line with this government direction of “Cloud First”, which requires public sector organisations to consider internet cloud solutions first before other options.

What is Internet First?

The Internet First policy advises that all new externally accessible digital services provided by NHSD should be internet cloud facing and that existing digital services should be brought in line at the earliest possible date.

Making digital services available over the cloud supports the requirements for health and social care professionals to work flexibly from a variety of locations, using a range of accessibility methods.

Alongside the Internet First policy being in line with the Secretary of State’s aspirations, it also aligns to the NHS Long Term Plan objectives to – increase productivity of NHS Staff and deliver digitally enabled care. The Internet First Policy supports the strategy and governance to remove the reliance of health and social care digital services on a central private network.

What are the principles of Internet First?

  • To design and develop digital services to be securely accessible over the internet.
  • Where a digital service can be migrated or performed by a shared service presented over the internet, the application should be retired, and the functionality provided by the shared service.
  • Internet facing digital services should be designed to be shared and re-used. They should avoid bespoke features that constrain re-use.
  • Existing digital services should be developed to be accessible over the internet at the earliest opportunity. Near-term opportunities to achieve this within planned development lifecycles should be exploited to achieve early delivery over the internet.
  • Transforming digital services to be presented over the internet must not introduce additional risk to live services.
  • Data sensitivity analysis must be carried out prior to exposing digital services to the internet.
  • Investments in new and existing digital services must support universal access for consumers.
  • Users must be kept informed to ensure business continuity is maintained during migration to the internet. In particular, application sub-component dependencies should be managed carefully where systems are integrated.
  • Ensure users are sufficiently prepared to access the digital services they need over the internet (for example have sufficient bandwidth, resilience and quality of service).

How will NHS Digital deliver Internet First?

 To support the Secretary of State’s aspirations, and to also align to the NHS Long Term Plan, NHS Digital has been asked to:

  • Define the minimum set of standards to which systems and networks should be aligned.
  • Consider the future network provision across health and social care.
  • Provide guidance and support for the remediation of digital services in health and social care so that they are presented over the internet.

 Internet First means that externally accessible health and social care digital services must be securely accessible over the public internet and this will require:

  • Health and social care organisations to have sufficiently scaled and functional internet connectivity to support the needs of the organisation in consuming and where applicable providing internet hosted services.
  • IT service providers to offer suitable secure user access to externally accessible systems and services over the internet.
  • IT service providers to offer suitable secure application interfaces to externally accessible system and services over the internet.
  • Digital services to be accessible over the internet at the earliest opportunity.

How can 4C Strategies help?

Parts of the NHS are already starting to deliver projects which are as a result of the NHSD and the Long Term Plan and this now needs to be continued throughout the establishment.

4C Strategies are a team of professional and independent consultants who can help prepare for this transformation. With over 20 years’ experience working with the healthcare sector, 4C offers unified solutions to the healthcare industry, providing end-to-end support on ICT projects, by delivering a portfolio of consultancy services to meet client requirements. The team can assist with the entire lifecycle, including strategy, business case, procurement and transformation. Further information on how 4C Strategies can help and the experience they have can be found  here.

Please contact 4C Strategies on 01858 438938, or email for further information.

Useful information links

NHS Digital

NHS Digital Capability Review Report

NHS Digital Data & Information Strategy

NHS Long Term Plan

NHS Digital Transformation, is your Infrastructure ready?

Digital Transformation in the NHS