NHS Dorset

Email Encryption

Background

Local guidance has already been issued to staff regarding the circumstances in which e-mails should be encrypted (basically those e-mails containing sensitive information such as ‘person identifiable’ data like name, address and postcode). This e-mail outlines new facilities available to you to encrypt sensitive e-mails. The existing facilities such as national NHS Mail (@nhs.net) and Secure Send (http://securesend.dorset.nhs.uk) are still available but you may prefer to use the new encryption facility that uses a system called ‘IronPort’. All NHS Trusts in the county of Dorset have installed identical ‘IronPort’ mail encryption systems.

Please note that when encrypting emails, attachments are also encrypted whether automated/seamless or manual encryption is used.

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How do I encrypt e-mails using the new system ?

A. Automated / Seamless Encryption

Where e-mails are sent from PCT e–mail systems to NHS organisations within the county of Dorset using e-mail addresses ending in @something.nhs.uk for both the sender and recipient (such as @dorset.nhs.uk, @bp-pct.nhs.uk, @dchft.nhs.uk) these e-mails are automatically encrypted by the e-mail system. The e-mails are also automatically decrypted by the receiving organisation. No action is required by either the sender or the recipient. Please note the only exception to this rule is the Lyme Regis Medical Centre which uses its own mail server using @gp-J81088.nhs.uk. Therefore, sensitive e-mails sent to this Practice will need to be manually encrypted (see below).

For example:

joe.bloggs@dorset-pct.nhs.uk to fred.smith@dchft.nhs.uk is secured automatically
andrew.brown@dorset.nhs.uk to jane.white@poole.nhs.uk is secured automatically
fran.smith@bp-pct.nhs.uk to Amanda.white@hotmail.com is not secure (use manual encryption)
simon.hughes@bp.nhs.uk to ann.harris@hampshirepct.nhs.uk is not secure (use manual encryption)
joe.bloggs@dorset-pct.nhs.uk to fred.smith@nhs.net is not secure (use @nhs.net accounts to send to other @nhs.net accounts – see Note 3 below)

B. Manual Encryption

Where confidential or sensitive e-mails are sent outside of NHS Trusts within the county of Dorset these need to be manually encrypted. You can do this by one of 2 methods:

  1. Use [encrypt] in the subject header

    2. E-mails can be encrypted by placing the phrase ‘[encrypt]’ in the subject header (without the quotes). This results in an encrypted e-mail being sent to the recipient. The subject line is not encrypted so sensitive information should not be placed there. The recipient can open the encrypted e-mail via a web-site. This requires password registration on the web-site – a link to this web-site is sent with the mail along with simple instructions for the recipient;

  2. Mark the sensitivity of the e-mail as confidential

    3. E-mails can be marked as confidential – see the message options when compiling an e-mail. Changing the sensitivity to confidential results in an encrypted e-mail being sent to the recipient. Again the subject line is not encrypted so sensitive information should not be placed there.

    Where you send a manually encrypted e-mail, it might be a good idea to warn recipients beforehand that you are sending an encrypted e-mail. Guidance for recipients opening encrypted e-mails is sent with the e-mail in the non-encrypted part but further detailed guidance for 3rd parties is available at the following link:

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Further information

Here are a list of e-mail addresses that are automatically encrypted and we will keep this up-to-date as other sites are added. It is hoped that Local Authorities will soon adopt a similar solution which will deliver automated encryption between Dorset NHS and Local Authority organisations.

Please note that it is not yet possible to send encrypted mail using IronPort to NHSMail (@nhs.net). This is awaiting a software ‘fix’ to be applied to the national NHS mail system – we expect this to be applied in December. In the interim use @nhs.net to send sensitive e-mails to @nhs.net as this is encrypted.

Finally please note that it is not possible to deliver seamless encrypted e-mail in all circumstances which requires no additional action on behalf of users or recipients. This would require shared and agreed standards with all individuals we e-mail which is currently not possible. However, this new encryption facility will be helpful in ensuring that the PCT meets its obligations in respect of NHS security standards.

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Information for Blackberry Users

If you receive a manually encrypted message on a Blackberry (which will not be from local NHS Trusts as these are decrypted by our local encryption devices) forward the message you receive to mobile@res.cisco.com

The service will then send you an email message back with a temporary link that you can click to securely retrieve the message by using a web browser on your computer or Blackberry. for more information about using the Open Online method and the Open by Forwarding method, see the Registered Envelope online help at the following website https://res.cisco.com/websafe/help?topic=RegEnvelope

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FAQs

Q: Why isn’t encryption enabled by default for all e-mails ?

A: It is technically possible to turn on encryption by default (we did consider doing this at some length) and this is our medium term aim. We could not enable it by default for these reasons:

  1. About 10% of mails can’t be opened by recipients. They either have web filtering / blocking software installed by their organisation or they don’t have a java client software (plug-in) installed in the browser which is required to open the encrypted message

  2. Mails sent to the national NHSmail service (@nhs.net accounts) cannot be opened in Outlook Web Access – this is a problem with MS Exchange Server 2007 – there is a fix available but Connecting for Health are not able to apply this until approximately December 2009 at the earliest. A significant number of our users use this service so this would severely disrupt mail flow which we must avoid.

On balance switching on encryption by default would disrupt mail flow which would be more of a risk (including clinical risk) – so we decided not to do it. Where messages cannot be opened by recipients users must fall back to other encryption methods that are available. We will re-consider enabling encryption by default in December 2009 when the national NHS mail service has been patched.

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