NHS Health and Social Care Information Centre: N3 takes voice into the cloud to save cash


Health and Social Care Information Centre sees huge phone call cost reductions with next-generation N3 cloud-based voice services

One of the largest broadband VPNs in Europe, N3 initially focused on supporting much-needed national healthcare applications such as the NHS Care Records Service. But Paul Everson and his colleagues in the Health and Social Care Information Centre (HSCIC) had a vision of saving money for the NHS by carrying telephone calls over converged N3 capacity.

The newly-launched NHS Voice Service was trialled with 1,600 users in HSCIC, and Paul measured annual savings of £200,000. NHS users across the country are now jumping on board. N3 was always about a healthier nation, but now it’s about a healthier NHS bottom line too.

With no obligation for different parts of the NHS to use N3, the capability has to sell itself. With nearly 150 sites using the N3 Voice Service, representing about 15 per cent of NHS staff, the message is clearly getting out there.”
- Paul Everson, ICT Architect and Infrastructure Manager Health and Social Care Information Centre


One of the largest broadband virtual private networks in Europe, the National Health Service (NHS) N3 infrastructure has 63 points of presence and in excess of 51,000 connections running over 12,000 kilometres of optical fibre. Benefitting a population of more than 50 million, it also provides an internet gateway for the 1.3 million people employed by the NHS.

The use of N3 was initially focused on supporting much-needed national healthcare applications such as the NHS Care Records Service. More recently, it was seen that there was an opportunity for cost savings from the 23 million telephone calls made by NHS staff every year. Historically, NHS departments had used the public switched telephone network (PSTN) for voice calls. A quarter of such traffic travelled between NHS offices, while the remaining 75 per cent went to external landlines or mobiles.


The Health and Social Care Information Centre (HSCIC), part of the Department of Health Informatics Directorate, has overall responsibility for the development and deployment of N3, while BT acts as the N3 Service Provider (N3SP) to assure value for money connectivity from chosen carriers. In addressing the challenge of reducing NHS call costs, BT and HSCIC co-operated to create a cloud-based voice service that would take advantage of the converged N3 architecture.

“A sense of urgency always encourages innovation,” says Paul Everson, ICT architect and infrastructure manager at HSCIC . “That’s never been more evident than with the fast-increasing focus on cash releasing initiatives in the NHS.”

The first priority was to ensure that internal NHS calls were detected and carried over N3 to avoid external charges. To achieve this, individual NHS sites can choose from N3 Voice Service options according to local circumstances. The Hosted Voice Service (HVS) transports calls end-to-end over N3 alongside other IP traffic. Alternatively, the Local Gateway Service (LGS) allows non-IP private branch exchanges to take advantage of the N3 network through protocol and signalling conversion.

Secondly, to further save money, calls needed to be aggregated to take advantage of the huge spending power of the NHS. Two N3 voice nodes were created in data centres in Plymouth and Gloucester, not only to concentrate all NHS outgoing voice traffic but also to serve the N3 Voice Service to its users.


Telephone calls between any two locations on the N3 network can now be automatically detected and forced onto the N3 network (on-net) to avoid call charges. Meanwhile outgoing phone calls to non-N3 destinations are routed to either the Plymouth or Gloucester voice node from where they are forwarded via the PSTN. That means that traffic can be measured and charged under an NHS-wide BT telephony contract to maximise volume discounts.

That consolidation of outgoing phone calls also greatly reduces the need for PSTN lines at NHS buildings that have moved to the N3 Voice Service. This saves on line rentals because the new circuits provided at Plymouth or Gloucester can be brought under the NHS-wide discount scheme. It also ensures optimum use by accurately matching the number of lines to the traffic.

With some 1,600 staff spread across 12 locations, HSCIC was an ideal test bed for the new N3 Voice Service. “Before the rollout of any major NHS communication solution, we always take a dose of our own medicine first to measure its efficacy,” says Paul Everson, “and we’ve seen annual savings of some £200,000 per annum.”

With the Plymouth and Gloucester voice nodes controlling all N3 Voice Service traffic, resilience is paramount. Paul Everson says: “If either data centre had a major outage all services would automatically failover to the second site. Dual routing into both data centres and the inherent ability of the N3 network to redirect calls in the event of a failure means calls can be guaranteed to reach their destinations.”

Furthermore, the N3 Voice Service offers a catalogue of shared service options—such as interactive voice response, voicemail, and call recording—served from the Plymouth and Gloucester voice nodes.

“Higher quality calls at lower cost means more resources can be directed to patient care,” concludes Paul Everson. “When extended across the NHS as a whole the N3 Voice Service has the potential for truly enormous savings.”

Core Services

  • N3 Voice Service