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October 2021
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NHS Connecting For Health

For NHS staff, accessibility, collaborative working and the reassurance that sensitive information is secure and remains confidential are top priorities when it comes to communications. That’s why increasing numbers of organisations are switching off their local email services in favour of NHSmail, the national email and directory service for the NHS in England and Scotland


At the start of the project the vision was to build a single shared service platform which could be scaled to support the whole user base in the NHS. This would encourage organisations to switch off locally supported communication services in favour of NHSmail,
Building on the success of the first generation platform, the new service would have the potential to benefit nearly one million healthcare professionals across the NHS who were either still using locally supported, unsecured platforms or had no access to communication tools.


Under a contract that has run since 2004, Cable&Wireless has worked closely with NHS Connecting for Health to provide a fully managed enterprise email service to the NHS.
The first generation NHSmail platform successfully supported 350,000 users however requirements for the development of the service had changed with an increasing need for collaboration and mobility features.. It was time to consider moving to a more familiar and feature rich platform and it became clear that Microsoft had made great strides in the provision of a large scale public sector email service.

In 2007 the decision was taken to migrate users to a new platform based on Microsoft Exchange 2007 to meet the evolving requirements of the service and allow for potential future developments such as incoming SMS and collaboration tools.


With new NHSmail, staff benefit from access to a service that is accredited to Government Restricted level, allowing them to safely share sensitive information with NHS colleagues as well as local authorities and government. NHSmail is the only NHS email service with this level of security, which is why it’s approved by the Department of Health and endorsed by the British Medical Association, Royal College of Nursing and Chartered Society of Physiotherapy.
Crucially, organisations stay in control of their accounts – locally appointed administrators have access to a bespoke management portal developed by Cable&Wireless.

Tools are provided allowing them to perform administrative tasks such as resetting passwords and managing mailbox quotas. Organisations within the NHS benefit from access to a nationally shared platform whilst retaining local Administrative control. This allows existing email services to be decommissioned, IT resources freed up and costs reduced. In these challenging economic times, NHS staff are under pressure to deliver more for less with NHSmail, monthly email management costs could fall by up to 80%.

And NHSmail is centrally provided, availability is guaranteed with full disaster recovery and an ISO2000 accreditation gives organisations confidence in the service provided for their staff. In addition all email traffic is monitored 24×7 and accounts are protected by cutting edge anti-spam and anti-virus protection.

Representing the gold standard in functionality, NHSmail offers a range of features that enable staff to send a mix of email, fax and SMS text messages. It incorporates a full electronic calendar and folders that can be shared with colleagues across organisation boundaries.


For NHS staff, accessibility, collaborative working and the reassurance that sensitive information is secure and remains confidential are top priorities when it comes to communications

The NHS traditionally communicates by letters and phone calls, so patient care, referrals and follow-ups take time. With NHSmail, processes are e-enabled, speeding up communications and improving patient care. NHSmail allows organisations to provide their staff with the tools to carry out their jobs more effectively.

Staff also benefit from access to the powerful and data rich national directory containing the professional contact details of over a million staff across the NHS. Using NHSmail as a collaborative tool means that clinicians can seek the expertise of others regardless of where they are in the country. And this is helping to create -virtual communities where knowledge, expertise and different working practices are shared among those in similar areas of medicine and administration.

For NHS staff that work across multiple organisations or in the community, NHSmail allows them access to stay connected wherever they are. With full push email on over 200 mobile devices including the Blackberry, a Community Nurse equipped with a mobile device can avoid trips to base, maximising productivity and allowing more time for patients.

The fastest growing element is use of the SMS feature showing how changes to working practices in the NHS are being implemented at local levels. On average 35,000 SMS messages are sent via NHSmail every day to reduce appointment no shows, as well as for other communication such as flu jab reminders and relaying weather warnings to patients who suffer from diseases such as chronic bronchitis and emphysema. Innovations such as these save time and money and benefit both staff and patients.


Migrations began in January 2009 and over 11 weekends more than 350,000 accounts were moved to the new platform, reaching a peak when a massive 47,000 accounts were migrated in just 48 hours. With an unprecedented success rate, Cable&Wireless achieved the biggest and fastest enterprise email migration of its kind ever. And with the capability of serving one million users, the service is the largest Exchange 2007 implementation of its type in the world
Use of the service is accelerating at a great pace with an average of 12,000 new users joining the service per month. By 2011 it’s estimated that NHSmail will be used by half a million NHS staff and on a typical day over 100,000 users log in and send and receive an average of 1.6 million messages.

The new platform delivers
 Security to Government Restricted level and Anti Virus & Spam services
 Business Continuity via dual site resiliency
 Mobile email SMS & Fax capability
 Public Sector Search – National Directory searchable at a local organisational level
 Folder Sharing – open, subscribe to and share folders with any other user on the platform
 Delegation of permissions to other users within enhanced Outlook Web Access (OWA)
 Enhanced OWA – Richest Web Mail experience gives option to reduce costs and replace older Outlook versions
 Administration Portal – organisations retain control of administration
 Extensibility – new web services can be added to the end user or administration portal.

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